‘Rice bodies in the knee’: classic tuberculosis of the knee

A 32-year-old man presented with left knee pain and swelling of 8 months duration. The pain was insidious in onset and associated with swelling of the left knee. History was unremarkable; there were no major diseases or surgery. There was no history of fever or injury to the knee. Initially the patient consulted a local doctor and was treated with analgesics. However the pain and swelling persisted for which he was referred to our hospital. Clinical examination of the left knee revealed swelling which was parapatellar and on palpation was suggestive of synovial thickening and hypertrophy. Knee movements were full but terminally painful. Provocative tests to evaluate meniscus and ligaments were normal. Radiographs of the left knee joint (figure 1) revealed patchy periarticular osteoporosis with well-maintained joint space. Blood investigations revealed an elevated erythrocyte sedimentation rate of 58 mm and C reactive protein was positive (1:32). MRI scan of the left knee …

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