Chronic Tubercular Osteomyelitis of Medial Cuneiform and its Management: A Rare Case Report

Background: Chronic tubercular osteomyelitis of the foot is an uncommon subset of skeletal tuberculosis, with the calcaneum being the most frequently affected site. The involvement of navicular and cuneiform bones is particularly rare. This case report is significant due to the unusual location of the infection in the mid-tarsal bone following a traumatic injury, highlighting the importance of considering tuberculosis in differential diagnoses for persistent foot pain and swelling. Case Presentation: A 29-year-old woman presented with persistent pain and swelling in her right foot for one year, symptoms that began a year after an eversion injury from a slip and fall. The pain and swelling intensified and localized below the medial malleolus on the inner side of her right foot. Surgical debridement was performed, and intra-operative tissue samples tested positive for tuberculosis. The patient was subsequently treated with a regimen of anti-tubercular medications. After one year of follow-up, the wound healed well with no recurrence of symptoms. Conclusions: This case underscores the importance of a thorough evaluation and appropriate treatment for foot injuries, especially when persistent pain and swelling occur. It also highlights the necessity of considering tuberculosis as a potential underlying cause, even in unusual locations and following traumatic injuries. Early identification and intervention are crucial for preventing chronic complications and ensuring favorable outcomes.