Intervention:
The patient was planned for surgical biopsy at distal tibia in order to establish tissue diagnosis.
Surgery was done after proper counselling and informed consent. It was done under the effect of spinal anaesthesia. Surgical intervention in form of curettage of the distal tibial lesion through anterior approach. The skin, subcutaneous tissue, extensor retinaculum and ankle joint capsule were opened respectively. The periosteum of the anterior tibia was opened and small bone window was formed. The tibial cyst was approached through this window and biopsy is taken from the lesion with no need for bone graft. Careful protective curettage was achieved and taken for histopathology and gene expert analysis. The patient was mobilized immediately post-operatively using long walker boot for 6 weeks. The patient underwent uneventful post-operative recovery period without complications.
After the confirmation of the diagnosis of TB with the biopsy and gene expert test, with consultation of senior chest physician the patient fitted to anti-tuberculous regimen.