{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T08:31:06Z","timestamp":1773304266107,"version":"3.50.1"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      Tuberculous osteomyelitis is a rare type of bone infection caused by\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis hominis.<\/jats:italic>\n                      It accounts for approximately 1\u20133 % of all TB cases and up to 35 % of extra pulmonary cases, with the distal tibia being an uncommon site of infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 28-year-old male, who suffered a blast injury 4 years prior, presented with a worsening pain in the left distal leg and ankle, accompanied by purulent abscess formation and pus discharge. After a trivial fall, X- ray imaging showed a lytic lesion in the distal tibia with a pathological fracture. Surgical intervention involved debridement and curettage of the lesion with external fixation. An excisional biopsy obtained for pathological analysis later confirmed tuberculous osteomyelitis. Following diagnosis, the management included a quadruple anti-tuberculosis regimen, and the patient demonstrated a significant improvement during a short period of time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Extra-pulmonary tuberculosis mainly affects patients with impaired immune function. However, approximately 1\u20133 % of immunocompetent individuals can also develop musculoskeletal TB, posing a significant diagnostic challenge. Radiological evaluation includes plain X-rays, computed tomography and MRI. While biochemical tests support the diagnosis, PCR assay and histopathology remain the gold standards. Regarding the management, 6- to-9 months regimens including rifampin are effective, while surgery is typically reserved for cases requiring biopsy and to manage complications in order to expedite healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Tibial tuberculous osteomyelitis is a rare diagnosis that requires a high index of suspicion in adults presenting with unexplained bone pain and swelling, especially those who underwent several previous orthopaedic surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.111475","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T19:49:37Z","timestamp":1749066577000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Tuberculous osteomyelitis of the distal tibia: a rare case report from Syria"],"prefix":"10.1097","volume":"132","author":[{"given":"Mohammed","family":"Mayo","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Aleppo University, Aleppo, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama Haj","family":"Osman","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Aleppo University, Aleppo, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Besher","family":"Alsakkar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Aleppo University, Aleppo, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramez","family":"Barrieh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Aleppo University, Aleppo, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameer","family":"Abdulkareem","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Baghdad Private Hospital, Baghdad, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mousa","family":"Saheel","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Baghdad Private Hospital, Baghdad, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"4","key":"R1-37-20260311","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.foot.2014.07.006","article-title":"Foot and ankle tuberculosis: case series and literature review","volume":"24","author":"-Korim","year":"2014","journal-title":"Foot (Edinb.)"},{"issue":"2","key":"R2-37-20260311","doi-asserted-by":"crossref","first-page":"172","DOI":"10.4103\/0970-2113.152645","article-title":"Tubercular and bacterial coinfection: a case series","volume":"32","author":"Arora","year":"2015","journal-title":"Lung India"},{"issue":"7","key":"R3-37-20260311","first-page":"95 98","article-title":"Coinfection of Streptococcus agalactiae and tuberculous osteomyelitis of tibia mimicking Brodie's abscess in an immunocompetent adult: a case report","volume":"13","author":"Ajit","year":"2023","journal-title":"J. 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