Affiliations: Department of Pediatrics, Pediatric Rheumatology
Clinic, North Bengal Medical College, Sushrutnagar, Darjeeling, West Bengal, India
Note: [] Correspondence: Rakesh Mondal MD, DNB, MNAMS, Associate
professor, Department of Pediatrics, North Bengal Medical College,
Sushrutnagar, Darjeeling, Balarampur, Mahestala, Kolkata-141, India. Tel.: +91
9674240973/033 64143736; E-mail: rkm1971@indiatimes.com
Abstract: We report a child with multiple joint swellings, being treated as a
case of poly-articular juvenile idiopathic arthritis subsequently turned out to
be tubercular origin. Development of overlying sinuses, lytic lesions on
radiographs, synovial fluid analysis showing tubercular infection and
demonstration of epitheloid granulomas on bone biopsy confirmed the diagnosis
of tubercular poly-arthritis with dactylitis. Child was asymptomatic after two
months of starting antitubercular treatment. The case highlights the need to
consider the possibility of tuberculosis as aetiology of poly-arthritis, at
least in endemic areas, even in the absence of a tuberculosis contact history
and overt pulmonary symptoms.
