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Ankylosis of the knee joint

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Chronic painful left genu flexum. Past-history of knee surgery 25 years ago.

Patient Data

Age: 75 years
Gender: Female
x-ray

The AP and lateral radiographs show a bony ankylosis of the left knee involving the femorotibial as well as the femoropatellar joints.

Case Discussion

According to the patient's family, she had surgery for tuberculous athritis (end-stage tuberculous arthropathy) for which she was not treated on time.

The musculoskeletal system is involved in 1to 3% of patients with tuberculosis and accounts for approximately 10 to 11% of extrapulmonary cases. Usually tuberculous arthritis is monoarticular; however, in approximately 10% can be polyarticular. It involves mainly the large weight-bearing joints (hips, knees, and ankles). 

The diagnosis of TB arthritis may be delayed, because it can mimic other infectious arthritis due to the nonspecific and often indolent clinical presentation and nonspecific radiographic appearance.

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