Polyarticular tuberculosis missed diagnosed as juvenile idiopathic arthritis
14 July 2011
24 August 2011
28 July 2015 (online)
We report a child with multiple joint swellings, being treated as a case of poly-articular juvenile idiopathic arthritis subsequently turned out to be tubercular origin. Development of overlying sinuses, lytic lesions on radiographs, synovial fluid analysis showing tubercular infection and demonstration of epitheloid granulomas on bone biopsy confirmed the diagnosis of tubercular poly-arthritis with dactylitis. Child was asymptomatic after two months of starting antitubercular treatment. The case highlights the need to consider the possibility of tuberculosis as aetiology of poly-arthritis, at least in endemic areas, even in the absence of a tuberculosis contact history and overt pulmonary symptoms.