A Case Report of Tuberculosis of Isolated Radial Head A Rare Location with Diagnostic Dilemma

INTRODUCTION: Tuberculosis (TB) of isolated radial head is scantily reported in the literature. Nonspecific symptoms and difficulty in interpreting initial screening radiographs often lead to misdiagnosis. CASE REPORT: We present a case of 42-year-old male elsewhere diagnosed as pyogenic arthritis of left elbow and treated by incisional drainage and broad-spectrum antibiotics, who presented to us 6 months later with multiple non-healing actively discharging sinuses. The repeat radiographs and Magnetic Resonance Imaging (MRI) were reported as chronic osteomyelitis of proximal radius without the involvement of humerus and ulna. The excision of radial head along with sinus tracts was done for clearance of disease and excised tissues, on being subjected to Cartridge Based Nucleic Acid Amplification Test (CB-NAAT), culture and histopathological examination, the diagnosis of TB was established. CONCLUSION: The diagnosis of TB of the elbow is generally delayed & mismanagement may occur. Therefore, not only biopsy is essential to demonstrate the presence of mycobacterium TB by CB-NAAT (Cartridge Based Nucleic Acid Amplification Test) method and in culture but also the presence of tuberculoma in histopathology is essential to establish the diagnosis so that early appropriate treatment can be instituted.