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ORIGINAL ARTICLE
Year : 2014  |  Volume : 3  |  Issue : 2  |  Page : 129-131

Ankle and foot tuberculosis: A diagnostic dilemma


1 Department of General Surgery, S.C.B. Medical College, Cuttack, Orissa, India
2 Department of Physiology, S.C.B. Medical College, Cuttack, Orissa, India
3 Department of Pulmonary Medicine, S.C.B. Medical College, Cuttack, Orissa, India

Correspondence Address:
Biswaranjan Nayak
Room no. 117, Old Gents Hostel, S.C.B. Medical College, Cuttack, Orissa - 753 007
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4863.137629

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Aim and Objective: To know the biological behavior of ankle and foot tuberculosis (AFTB) and to know the reasons for delay in diagnosis and treatment of AFTB in our population. Materials and Methods: Patients with non-healing ulcers/sinuses/swellings in the ankle and foot region are the subjects of present study. Detailed clinical history, physical examination and relevant investigations were done in all cases. Pus/wound discharge for acid fast bacillus (AFB) study and biopsy from wound margin/sinus tract was taken in all the cases. Results: During the period from July 2007-June 2012, 20 cases of AFTB were treated. Out of them five cases were difficult to diagnose and a mean period of 6 month to 5year was elapsed before final diagnosis was established. Out of these five cases - three cases were diabetic with ulcers and sinuses in the heel and ankle region. One case was wrongly diagnosed as angiodysplasia with A-V malformation of foot and diagnosis was delayed for 5 year. In one case of rheumatoid arthritis with abscess in ankle joint, the diagnosis was delayed for 1year. Conclusion: AFTB is very rare condition. AFTB is suspected in cases with long standing pain/swelling/discharging sinus in the foot and thorough investigations is must to differentiate from other foot diseases. Diagnosis is delayed due to lack of clinical suspicion and non-confirmatory biopsy reports. Early diagnosis and ATT for 9-18 months is must in all cases of AFTB to prevent joint involvement and other complications.


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