A Case of Therapeutic Diagnosis of Multiple Osteoarticular Tuberculosis in The Chronic Hemodialytic Patient

Background: Patients in chronic hemodialysis often have compromised immune system and they are sometimes complicated with tuberculosis. In addition, the prevalence of extrapulmonary tuberculosis in them is high and the diagnosis tends to be delayed. A 49-year-old woman who received hemodialysis for 7 years due to chronic renal failure manifested mild fever and severe pelvic and bilateral acromioclavicular joints and used antibiotics and corticosteroids and NSAIDs at home. However, symptoms exacerbated and a tumor, appearing in the bilateral acromioclavicular joints caused motion disability. For diagnosis and treatment she was admitted to the hospital. To find out the cause of pain and edema of bilateral acromioclavicular joints and pelvic joint, we had several lab tests and imaging tests and consulted with oncologists and phthisiologists for three months but we couldn’t diagnose. We did anti-tuberculosis treatment suspecting of tuberculosis and as a result, symptoms alleviated. Therefore, we diagnosed her as multiple osteoarticualr tuberculosis therapeutically.