Tuberculosis of Distal Ulna: A Case Report

Abstract The occurrence of tuberculosis in the wrist constitutes a rare manifestation. Predominant sites for primary osseous tuberculosis involvement are typically the capitate bone or the distal end of the radius. The presentation of wrist tuberculosis as an isolated lytic lesion in the distal ulna represents an exceptionally infrequent phenomenon, frequently resulting in misdiagnosis as malignancy and consequent delays in therapeutic intervention. Herein, we report the case of a 23-year-old healthy man with persistent ulnar-sided pain in his left wrist over the past 1 year. Radiographs disclosed a small lytic lesion in the distal ulna correlating with the site of tenderness. Subsequent comprehensive imaging modalities including NCCT, MRI, and three-phase bone scan with SPECT-CT were employed indicating a diagnosis suggestive of osteoid osteoma. Subsequently, the patient underwent surgical intervention in the form of lesion curettage, with specimens sent for histopathological examination (HPE), ultimately revealing tuberculosis as the underlying pathology.