Tuberculosis of talus bone in middle aged man - A case report

This case has been reported because of its rarity and atypical presentation. A 45 year old man presented in the outpatient department with a gradually increasing swelling over the antero-medial aspect of right ankle joint. This had developed over the last 3 months and the patient was experiencing pain while walking. On laboratory evaluation, he only had an elevated erythrocyte sedimentation rate. X-ray showed an extensive lytic lesion of the talus. Chest X-ray was normal. The Mantoux skin test was negative. Ziehl-Neelsen staining of aspirated fluid revealed acid-fast bacilli. Sequestrectomy with curettage with subsequent bone grafting was undertaken as an alternative to talectomy. Postoperatively a below knee cast was applied for 12 weeks with 20 months of antituberculous chemotheraphy, which resulted in a good clinical outcome. The lytic lesion had healed on X-ray.