A case of painful ankle swelling: Cytomorphological clues and pitfalls

Dey, Biswajit; Deshpande, Archana; Ojha, Pushpanjali R; Gargade, Chitrawati Bal; Nigam, Jitendra Singh; Ray, Amit

doi:10.4103/cytojournal.cytojournal_49_16

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Clinical features are atypical, like pain, swelling, and discomfort while walking, which are often indistinguishable from other musculoskeletal disorders [7]. However, certain presentations like painful swelling of the involved joint or bone with an insidious onset, a non-healing ulcer, and a sinus associated with a discharge should alert the treating clinicians [11].…”

Section: Discussionmentioning

confidence: 99%

Tuberculous Osteomyelitis of the Left Fifth Metatarsal and Phalanx Without Pulmonary Involvement: A First-of-Its-Type Report

Yadav¹,

Rawal²,

Jeyaraman³

2023

Cureus

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Tuberculosis manifesting at extrapulmonary sites is relatively rare. Isolated cases involving small bones of the foot are the rarest of the rare. We herein present the case of a 30-year-old Indian female who presented with pain and a wound with a discharging sinus over her left foot. In the absence of constitutional symptoms of tuberculosis, this case was diagnosed as isolated tuberculous osteomyelitis of the left fifth metatarsal and phalanx with the help of radiography, a cartridge-based nucleic acid amplification test, a line probe assay, a culture of the biopsy specimen, and magnetic resonance imaging. She was initiated on anti-tubercular treatment per national guidelines.

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Section: Discussionmentioning

confidence: 99%

Tuberculous Osteomyelitis of the Left Fifth Metatarsal and Phalanx Without Pulmonary Involvement: A First-of-Its-Type Report

Yadav¹,

Rawal²,

Jeyaraman³

2023

Cureus

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“…Although tuberculosis of foot and ankle bones accounts for about 10% of osteoarticular tuberculosis, a clinical differential of tubercular arthritis should be kept in mind especially in endemic regions like India. [ 7 ] Radiological findings of periarticular osteoporosis, marginal erosion, and joint space narrowing (Phemister triad) along with marked leukocytosis on synovial fluid cytology give clues to the diagnosis of tubercular osteoarthritis. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 7 ] Radiological findings of periarticular osteoporosis, marginal erosion, and joint space narrowing (Phemister triad) along with marked leukocytosis on synovial fluid cytology give clues to the diagnosis of tubercular osteoarthritis. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

Hypercholesterolemic arthritis: A case report with emphasis on synovial fluid cytology

Dey

Khonglah

Raphael

et al. 2020

J Family Med Prim Care

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Osteoarticular tuberculosis: A series of six cases diagnosed on fine-needle aspiration cytology

et al. 2022

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A few studies are dealing with the role of fine-needle aspiration cytology in diagnosing osteoarticular tuberculosis (TB). The present study was undertaken to study the cytomorphological features of six cases of osteoarticular TB throughout 1 year, diagnosed by fine-needle aspiration cytology. The Papanicolaou, Giemsa, Ziehl–Neelsen, and periodic acid–Schiff stains were used in each case. The sampled material was also cultured in Lowenstein– Jensen media for Mycobacterium species and polymerase chain reaction assay for Mycobacterium tuberculosis. Histopathological findings were correlated whenever available. There were four male and two female patients. The age of the patients ranged from 15 to 53 years, with a mean age of 37 years. Most cases involved small bones (4/6) and long bones of upper and lower limbs (2/6). Radiologically, the suspected lesions presented as osteolytic lesions, fractures, and joint destruction. The smears showed epithelioid cell granulomas in 5 out of 6 cases (83.3%), multinucleate and Langhans’ giant cells in 3 out of 6 cases (50%), and only necrosis in 1 case (16.7%). Inflammatory cells were seen in the background in 5 out of 6 cases (83.3%). AFB was positive in 3 cases (50%). Culture in Löwenstein–Jensen media, done in three cases, showed growth of M. tuberculosis. PCR showed positivity for M. tuberculosis in all six cases. Fine-needle aspiration cytology is an easy procedure that can be used for the diagnosis of osteoarticular tuberculosis. Cytomorphologically, smears show epithelioid cell granulomas, multinucleated and Langhan’s’ giant cells, and necrosis.

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A case of painful ankle swelling: Cytomorphological clues and pitfalls

Cited by 3 publications

References 13 publications

Tuberculous Osteomyelitis of the Left Fifth Metatarsal and Phalanx Without Pulmonary Involvement: A First-of-Its-Type Report

Tuberculous Osteomyelitis of the Left Fifth Metatarsal and Phalanx Without Pulmonary Involvement: A First-of-Its-Type Report

Hypercholesterolemic arthritis: A case report with emphasis on synovial fluid cytology

Osteoarticular tuberculosis: A series of six cases diagnosed on fine-needle aspiration cytology

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