DOI: 10.36347/sjmcr.2022.v10i01.004

Pages: 17-20

Introduction: Extra pulmonary TB is caused by dissemination of primary infection through blood and lymph to neighbouring regions like pleura, lymph nodes, bones and joints, where they remain dormant. Reactivation of the disease is caused by disorders of immune system. Skeletal TB consists of 2% of all TB cases and 10-35% of extrapulmonary TB cases. Skeletal TB in humerus are a rare occurrence accounting upto 1-2% of total skeletal TB cases. Here we present a case of proximal humerus tuberculosis which was misdiagnosed and treated as rotator cuff injury by local practitioners and adviced physiotherapy. Case report: The patient is a 16 years old female with humeral head osteomyelitis at bone tendon interface with biceps tendon involvement. We managed the case with MRI followed by CT guided biopsy and anti tubercular regimen was started based on histopathology reports. Patient had resolution of infection with good range of shoulder mobility and satisfactory function. Conclusion: The diagnosis of proximal humerus TB is clinically challenging due to confluence of nonspecific symptoms and X ray findings which misguides clinicians to misdiagnose it as rotator cuff pathology, frozen shoulder, pyogenic osteomyelitis or tumours. This leads to delay in treatment. Probability of skeletal TB should always be kept in mind in such cases, especially in endemic countries which will help in timely diagnosis and treatment.