Osteoarticular tuberculosis: The great mimicker still catches us out —a case report

A 79-year-old man of South Asian origin presented at the trauma and orthopedic unit of a district general hospital with atraumatic pain in his right elbow, which he had had for 6 months, and a persistent cough. Given the demographics of the patient and the presenting symptoms, there was high clinical suspicion of tuberculosis, which we investigated accordingly. Routine blood tests and radiographs of the chest and elbow did not give a specific diagnosis (Figure 1). In accordance with National Institute of Health and Clinical Excellence (2011) guidelines, a bronchial lavage was then performed. Samples were sent for microscopy and culture, looking specifically for acid-fast bacilli. The final culture results were reported after 8 weeks and were negative. The elbow was painful but not swollen, and there was no indication for further investigation at this stage.