Trochantérite tuberculeuse isolée

We report the case of a 40-year-old patient hospitalized for inflammatory pain involving the superior external part of the right thigh; which has been evolving for 8 months, without alteration of the general condition or fever. On physical examination, pain was elicited by applying direct pressure over right greater trochanter without signs of local inflammation. Laboratory tests did not show any inflammatory syndrome. Pelvis X-ray showed osteolytic lesion in the right greater trochanter with surrounding soft tissue thickening (Panel A). Bone scintigraphy showed hyperfixation on the right greater trochanter (Panel B). Pelvic TC scan revealed osteolytic lesion in the right greater trochanter containing multiple sequesters, with cortical irregularity and multi-partitioned collection at the level of the lesion (Panel C). Greater trochanter bone biopsy under scannographic control (Panel D), showed epithelioid and gigantocellular granuloma on histology associated with the presence of KB by means of fluid culture. The diagnosis of tuberculosis of the right greater trochanter was made Tuberculin intradermal reaction (IDR) was negative. The search for tuberculosis at other sites was negative. The patient underwent antituberculosis treatment for 12 months with favorable evolution. Tuberculosis is a rare, if not exceptional, cause of trochanteric pain today. Our study was particular given the absence of tuberculosis at other sites.