長期ステロイド使用患者に生じた結核性足関節炎の1例

A case of foot and ankle tuberculosis exacerbated during a long-term steroid use

骨関節結核は比較的まれな疾患で，関節リウマチ，化膿性関節炎などとの鑑別診断に迷い，治療が遅れることがしばしばみられる。今回，長期ステロイド使用患者に生じた結核性足関節炎を経験したので報告する。

A patient with CREST syndrome and normal radiography developed left foot arthralgia at the initiation of steroid treatment. After more than one year, an exacerbation of the symptom occurred and the patient was admitted based on the radiography, CT and MRI findings, including bone destruction, calcification, and marrow edema in the left Chopart joint. Foot and ankle tuberculosis was diagnosed based on the analysis of cyst fluid from the posterior ankle joint. Her symptoms are improved after treatment. Osteoarticular tuberculosis should be considered in patients with tuberculosis even through the disease is recently are.