Abstract
In the knee, involvement is mainly synovial, with local extension eroding the bone. Pure tuberculous osteitis is rare, with a few occasional reports. Patella tuberculosis is extremely rare.
We report the case of patella tuberculosis with 7-years decline.
A 10-years old boy suffered from knee siftness and pain. The patient had correct BCG vaccination.
Clinical examination was relatively unrevealing, with tenderness on palpation of the medial joint surface of the patella, patellar crepitation, and slight effusion.
On standard X-ray, the lateral view showed a circumferential rosette form with a light peripheral halo.
The patient underwent open surgery with a medial parapatellar approach and arthrotomy. Joint fluid was sampled. Direct exploration of the medial side of the patella found soft but continuous cartilage on palpation. The histoligical examination confirmed the diagnosis of tuberculosis.
The patient had 12 month anti-tuberculosis chemotherapy. After 7 years of the treatement, the patient had no recurrence and good clinical result.
Bone tuberculosis remains difficult to diagnose. Certain locations should always be borne in mind, however rare, in case of pandemic or immunodeficiency. In case of osteolysis, associated with abscess or not, infectious etiology is to be considered and appropriate samples should be taken. Diagnosis is confirmed by histology and bacteriology. The slow evolution of bone tuberculosis requires local treatment of lesions and abscesses. Antibiotherapy regularly ensures recovery.
