Poncet’s disease (tuberculous rheumatism) in a Nigerian male: a frequently overlooked diagnosis

Poncet’s disease is an uncommon syndrome and a reactive polyarthritis associated with active tuberculosis with no evidence of mycobacterial infection of the joint. The condition is different from tuberculous arthritis which is usually monoarticular and caused by direct tubercular involvement of the joint. There has been a paucity of case reports on Poncet’s disease in Nigeria despite the high incidence of tuberculosis. We report a case of a 45-year male who presented with inflammatory polyarthritis involving the knees, wrists, ankles, small joints of the hands bilaterally of four weeks duration. This was preceded by three week’s history of productive cough. Chest radiograph and sputum Gene Xpert revealed features consistent with tuberculosis. Synovial fluid from knee joint effusion showed no evidence of mycobacterium tuberculosis. He was diagnosed to have Poncet’s disease based on the clinical findings and investigation results. He was commenced on antituberculous medications with complete resolution of symptoms after two months. Poncet’s disease is a rare manifestation of tuberculosis and should be considered a differential in any case of active tuberculosis presenting with arthritis. The correct and prompt identification of this condition by clinicians is important with the aim of instituting the appropriate therapy.