Abstract

Introduction: Among extrapulmonary infections, tuberculosis of the ankle joint is very uncommon. Early diagnosis of tuberculosis of the ankle joint is quite difficult because of its uncommon site, non-specific sign & symptoms, and negligence 
Case report: A 38-year-old female presented with right ankle pain and swelling for 3 months with a history of twisting injury to the right ankle 3 months back. She had no history of infection in the past ( at least for the last 1-2 years). The only complaint she had was recurrent pain and swelling of the right ankle joint for which she was being managed conservatively for the last 3 months. When she came to the outpatient clinic, presented with a swollen and tender right ankle joint and she was afebrile. Magnetic resonance imaging was not sufficient to conclude the diagnosis. TB arthritis was diagnosed by diagnostic arthroscopy. Eventually, anti-TB therapy eradicated the infection 
Conclusion: Early biopsy and synovial fluid for a polymerase chain reaction, gene Xpert should be performed in all suspicious cases to confirm the diagnosis and management