Author(s):
Grenho, A ; Arcângelo, J ; Jordão, P ; Gouveia, C
Date: 2018
Persistent ID: http://hdl.handle.net/10400.17/4015
Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
Subject(s): HCC ORT; HDE ORT PED; HDE PED; Child; Female; Humans; Antitubercular Agents / therapeutic use; Capitate Bone / pathology*; Diagnosis, Differential; Edema / etiology; Magnetic Resonance Imaging; Range of Motion, Articular; Synovitis / complications; Synovitis / diagnosis*; Synovitis / diagnostic imaging; Synovitis / drug therapy; Tuberculosis, Osteoarticular / complications; Tuberculosis, Osteoarticular / diagnosis*; Tuberculosis, Osteoarticular / diagnostic imaging; Tuberculosis, Osteoarticular / drug therapy; Wrist Joint*
Description
We present a 10-year-old boy with 2-month duration non-traumatic wrist pain and inflammatory signs. Due to elevated inflammatory markers on blood tests, with an increase in radiocarpal and intercarpal joints synovial fluid and no bony lesions, the patient was submitted to wrist arthrocentesis for the suspicion of septic arthritis. The patient did not improve on conventional treatment, however. An MRI showed synovitis around the carpus and a lytic lesion of the capitate bone due to osteomyelitis. A biopsy was able to identify the causative agent as Mycobacterium tuberculosis, and the patient was treated with antibiotics. He improved significantly, with no pain and signs of normal capitate bone remodelling on the last radiograph.
