Tuberculosis Infection of the Ischial Tuberosity and That Recurred after 8 Years - A Case Report -

Soon-Eok Kwon; In-Ho Jung; Dong-Hyun Kim

doi:10.5371/jkhs.2011.23.1.79

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Kwon, Jung, and Kim: Tuberculosis Infection of the Ischial Tuberosity and That Recurred after 8 Years - A Case Report -

Case Report

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2011; 23(1): 79-82.

Published online: 31 March 2011

DOI: https://doi.org/10.5371/jkhs.2011.23.1.79

Tuberculosis Infection of the Ischial Tuberosity and That Recurred after 8 Years - A Case Report -

Soon-Eok Kwon, MD, In-Ho Jung, MD, Dong-Hyun Kim, MD^*

Department of Orthopedic Surgery, Cheongju St. Mary's Hospital, Cheongju, Korea.

^*Department of Orthopedic Surgery, College of Medicine, Catholic University, Seoul, Korea.

Address reprint request to In-Ho Jung, MD. Department of Orthopedic Surgery, Cheongju St. Mary's Hospital, 589-5 Jujung-dong, Sangdang-gu, Cheongju 360-568, Korea. TEL: +82-43-219-8143, FAX: +82-43-219-8447, wdgat@naver.com

Received 26 August 2010 Revised 2 March 2011 Accepted 2 March 2011

Abstract

Tuberculous infection of the ischium is a rare condition. It is recommended that antituberculosis chemotherapy is combined with surgical intervention. The patient in this case had an abscess on his right gluteal region and he had undergone an operation without antituberculosis chemotherapy. After eight years, an abscess recurred in the same area and he was treated with surgical resection. Antituberculosis chemotherapy was administered following histopathological confirmation of tuberculosis. At 1 year postoperatively, the patient had no pain and there was no evidence of recurrence.

Keywords: Pelvis, Ischial tuberosity, Tuberculosis, Recurrent

Figures and Tables

Fig. 1

Perianal fistula caused by abscess of the right ischial tuberosity.

Fig. 2

X-ray shows multifocal bony destructive lesion with round shape.

Fig. 3

CT scan showing areas of relatively well demarcated low density shades between the gluteus maxmius muscle and the ischial tuberosity.

Fig. 4

MRI showing enhancement of the marginal increase in signal extending along the hamstring muscle in (A) axial, (B) coronal, and (C) sigittal sections.

Fig. 5

A posterior surgical approach to the ischium.

Fig. 6

The removed tissue showed a cheese like appearance and was closed to the pattern of caseous necrosis.

References

1. Alvarez S, McCabe WR. Extrapulmonary tuberculosis revisited: a review of experience at Boston City and other hospitals. Medicine. 1984. 63:25–55.

2. Moon MS, Ok IY, Ha KY, Shin JC. Tuberculosis of the puboischium -Report of five cases-. J Korean Orthop Assoc. 1987. 22:1326–1332.

3. Siegel RS, Jacoby AW, Alicandri FP. A posterior surgical approach to the ischium. J Bone Joint Surg Am. 1981. 63:466–469.

4. Martini M, Ouahes M. Bone and joint tuberculosis: a review of 652 cases. Orthopedics. 1988. 11:861–866.

5. Abdelwahab IF, Kenan S, Hermann G, Lewis M, Klein M, Rabinowitz JG. Atypical skeletal tuberculosis mimicking neoplasm. Br J Radiol. 1991. 64:551–555.

6. Harris NH, Murray RO. Lesions of the symphysis in athletes. Br Med J. 1974. 4:211–214.

7. Singh O, Gupta S, Moses S, Jain DK. Spontaneous tubercular enterocutaneous fistula developing in the scar of a surgery done 14 years earlier. Saudi J Gastroenterol. 2009. 15:261–263.

8. Bhattacharyya AN. Tuberculosis of the ischium: a report of three cases. Aust N Z J Surg. 1973. 42:389–391.

9. García S, Segur JM, Combalía A. Tuberculosis of the ischium. Acta Orthop Belg. 1994. 60:238–240.

10. Spiegel DA, Singh GK, Banskota AK. Tuberculosis of the musculoskeletal system. Tech Orthop. 2005. 20:167–178.

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