UNASSIGNED: A 24-year-old female presented with pain and swelling over dorsum of the left foot from the past 8 months. On examination, there was a diffuse round shaped, solitary swelling measuring about 3.5 cm × 2.5 cm (approx.) with its surface smooth, non-pulsatile, non-fluctuant, non-transilluminant, non-compressible, and non-reducible present over dorsum of the left foot. Radiographic investigations revealed osteolytic lesion over the base of 3rd, 4th, and 5th metatarsals, middle and lateral cuneiforms and cuboid bones along with soft tissue swelling and diffuse transient osteopenia. Under spinal anesthesia, trucut biopsy of the mass revealed paucibacillary type of TB in histopathological examination. The patient was provided with ATT drugs in the form of intensive phase drugs (HRZE) daily for 4 months and continuation phase drugs (HRE) daily for 10 months according to the weight of the patient. The patient was followed up with erythrocyte sedimentation rate and C-reactive protein every 2 months once. The patient achieved a normal range of movements in the midtarsal joints except for the painful terminal range of movements. The patient was still under our follow-up.
UNASSIGNED: The cuboid is the second most involved tarsal bone. The diagnosis is not always frankly evident, and a high index of suspicion has to be maintained. Surgical intervention should be limited to biopsy only as multidrug chemotherapy alone is sufficient to achieve complete healing.
未经评估:一名24岁女性在过去8个月出现左脚背部疼痛和肿胀。在检查中,有一个弥漫的圆形,孤立性肿胀约3.5厘米×2.5厘米(约)其表面光滑,非脉动,非波动,非瞬态发光,不可压缩,和不可还原的存在于左脚的背部。影像学检查显示第3位底部有溶骨性病变,第四,和第五跖骨,中侧楔形和长方体骨伴随软组织肿胀和弥漫性短暂性骨质减少。在脊髓麻醉下,在组织病理学检查中,对肿块进行了活检,发现了少杆菌型TB。根据患者的体重,每天向患者提供强化期药物(HRZE)形式的ATT药物,持续4个月,每天持续期药物(HRE),持续10个月。每2个月随访一次红细胞沉降率和C反应蛋白。除了疼痛的最终运动范围外,患者在中骨关节中实现了正常的运动范围。患者仍在我们的随访中。
UASSIGNED:长方体是第二大受累骨。诊断并不总是很明显,必须保持较高的怀疑指数。手术干预应仅限于活检,因为单用多药化疗就足以实现完全愈合。