Tahir ÖĞÜT, Alper GÖKÇE, Hayrettin KESMEZACAR, Haydar DURAK, Hüseyin BOTANLIOĞLU, Rıfat ERGİNER

Aşil tendonunda izole tüberküloz tenosinovit: İki olgu sunumu

Tüberküloza bağlı tenosinovitin ayak tendonlarında görülmesi oldukça nadirdir. Bu çalışmada Aşil tendonunda yerleşim gösteren izole tüberküloz tenosinoviti olan iki olgu sunuldu. Olgulardan biri 19 yaşında kadın hasta idi; sol Aşil tendonu üzerinde şişlik ve ağrı yakınması vardı. Bu olguda komplet eksizyon ve antitüberküloz kemoterapi hastalığın iyileşmesi için yeterli oldu. Ameliyat sonrası dönemde altı aylık tıbbi tedavi sonunda hastanın manyetik rezonans görüntüleme (MRG) sonuçları normal bulundu, 27. aydaki kontrol MRG’de nüks görülmedi. İkinci olgu aynı zamanda romatoid artrit ve diyabet hastası olup yoğun sitostatik ajan kullanan 53 yaşında bir kadındı. Yakınmaları çömelmede, merdiven çıkmada zorluk, sağ ayak bileğinde şişlik ve ağrı idi. Hastada apse drenajı ve kistik kitle eksizyonu yapıldı. Antitüberküloz kemoterapi sonrası takiplerde ayak bileği bölgesinde hastalığa ait bulgu saptanmamış olmasına rağmen hasta miliyer tüberküloz nedeniyle altıncı ayda kaybedildi. Ayağın arkasında geçmeyen ağrı ve şişlik bulunan hastaların ayırıcı tanısında tüberküloz tenosinovit de akılda bulundurulmalıdır.

Anahtar Kelimeler:

Tüberküloz, osteroartiküler, Aşil tendon, Tenosinovit

Isolated tuberculous tenosynovitis of the Achilles tendon: A report of two cases

feet is very rare. Isolated primary tuberculous tenosynovitis of the Achilles tendon was detected in two women aged 19 and 53 years, respectively. The younger patient had a swollen and painful Achilles tendon in the left foot. Complete excision of the lesion followed by antituberculous chemotherapy for six months resulted in complete improvement. Magnetic resonance imaging showed normal findings at the end of six months and no recurrence after 27 months of follow-up. The older patient had diabetes and was on cytostatic treatment for rheumatoid arthritis. She had difficulty in squatting and climbing stairs due to swelling and pain in the right ankle. She underwent abscess drainage and excision of the cystic mass. Despite disappearance of symptoms in the affected ankle in the course of antituberculous chemotherapy, she died due to miliary tuberculosis in the sixth month. Tuberculous tenosynovitis should be considered in the differential diagnosis of patients suffering from persistent swelling and pain in the hind foot.

Keywords:

Tuberculosis, Osteoarticular, Achilles Tendon, Tenosynovitis,

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