Tuberculosis of the shoulder joint

Abstract

A 26 year old married female presented in April 2017 with the history of left proximal arm mild pain and gradual progressive swelling for the last 7 months around the shoulder. She was afebrile and did not experience night sweats. On examination, she had diffuse swelling with poorly define margins, measuring 14x7 cm left proximal arm. The overlying skin was normal. There was no discharging sinus. Axillary and cervical lymph nodes were not enlarged. Movement of the shoulder were painful and restricted. No distal neurovascular deficit was noted. Per-operatively 40ml of straw coloured pus with debris was removed with caseous material and scanty acid-fast bacilli were seen. Biopsy concluded that chronic granulomatous inflammation with necrosis of infectious aetiology such as tuberculosis. Anti tuberculosis therapy was started and given for 18 months. Treatment resulted in good range of motion and patient s was disease free.