DOI: 10.36347/sjams.2013.v01i05.0046

Pages: 538-541

Tuberculosis of the shoulder joint is rare entity. Here we are presenting a case of shoulder joint tuberculosis, sicca variant with seven months follow-up. A 23 years male patient, electrician by occupation came to the outpatient department with complaints of pain in the right shoulder since two months. Patient’s systemic examination and vitals were within normal limits and local examination of the shoulder joint revealed tenderness along the joint line, wasting of the deltoid, range of movements were restricted, abduction 40 degrees, internal rotation 30 degrees and external rotation 40 degrees. X-ray examination of the shoulder joint showed osteolytic lesions in the humeral head and in the glenoid with reduction in joint space. Histopathological examination after an open biopsy showed fragments of necrotic bony trabeculae, adjacent stroma showed large areas of necrosis along with confluent epitheloid granuloma containing langhan’s type of giant cells. These are surrounded by dense lymphoplasmocytic infiltration. Features are consistent with tuberculous osteomyelitis. Anti tubercular treatment (ATT) started according to the revised national tuberculosis control programme which classified him under category one. Follow up done at 1st, 3rd, 5th and 7th month with body weight, erythrocyte sedimentation rate and x-ray examination. At seven month follow up, complete pain relief was not achieved due to joint degenerative arthritis and the patient agreed for the arthrodesis and occupational modification.Tuberculosis of the shoulder joint: sicca variant is very rare. Diagnosis is made by clinical, radiological and histopathological examination. Treatment under category 1 of revised national tuberculosis control programme guidelines of seven months is sufficient to treat the shoulder joint tuberculosis. Follow up is done with body weight, erythrocyte sedimentation rate and serial X-ray examination to monitor disease process and guide further treatment.