Clinical case of bone tuberculosis in the foot: involvement of the calcaneus. Diagnostic challenge and possible primary infection

Osteoarticular tuberculosis is a rare form of extrapulmonary tuberculosis, and represents a real diagnostic challenge due to its atypical presentation and similarity with other bone pathologies. The case of a 20-year-old male patient with a history of pulmonary tuberculosis treated 5 years ago, who came to the emergency room due to edema, pain and functional difficulty in the ankle and heel, is presented. The computed tomography of the left foot showed a hypodense osteolytic-type lesion that affected two thirds of the calcaneus, thinning of the cortices and involvement in the support area of the calcaneus. Surgical treatment and sample collection were performed, the anatomopathological analysis of which showed the presence of granulomatous cells inside. Tuberculostatic treatment was started, achieving the patient's improvement. The objective is to highlight the importance of early diagnosis based on clinical and radiological findings to facilitate timely intervention and minimize adverse outcomes.