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PICTORIAL EDUCATION
Year : 2021  |  Volume : 13  |  Issue : 1  |  Page : 36-37

Spina ventosa: An often missed diagnosis


1 Department of Orthopaedics, Super Specialty Pediatric Hospital and Postgraduate Teaching Institute, Noida, Uttar Pradesh, India
2 Department of Pediatrics, ABVIMS and RML Hospital, New Delhi, India
3 Department of Pathology, Super Specialty Pediatric Hospital and Postgraduate Teaching Institute, Noida, Uttar Pradesh, India
4 Department of Microbiology, Super Specialty Pediatric Hospital and Postgraduate Teaching Institute, Noida, Uttar Pradesh, India

Correspondence Address:
Dr. Ankur Agarwal
Department of Orthopaedics, Super Specialty Pediatric Hospital and Postgraduate Teaching Institute, Sector 30, Noida, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jgid.jgid_198_20

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Rare and varied presentations of tuberculosis make it difficult for treating clinicians to arrive at the diagnosis. An adolescent female presented to the orthopedic outpatient department with slowly increasing swelling over the dorsum of the hand near the base of the third digit for 5 months. With multiple consultations, she was being treated with antibiotics as a case of abscess. On examination, the swelling was soft bulging with whitish watery discharge. Plain radiography revealed periosteal elevation with bony destruction of the proximal phalanx. Magnetic resonance imaging revealed signal intensity changes with collection suggestive of infection. Blood investigations were within the normal limits, except slightly raised erythrocyte sedimentation rate. A differential diagnosis of chronic osteomyelitis was performed. Since the swelling was growing with the overlying skin likely to give way, it was treated with incision and drainage. Cytology with Gram's and auramine staining helped in confirming the diagnosis of spina ventosa. Biopsy is the gold standard for diagnosis, and antitubercular therapy forms the mainstay of treatment.


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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008