Subcutaneous tubercular abscess (elbow)

Case contributed by Dr Maulik S Patel

Presentation

Non-traumatic pain in elbow for 2 weeks. C/o swelling on posterior aspect of elbow for a few days.

Patient Data

Age: 25 yrs
Gender: Female
Ultrasound

There is a collection with mobile echoes involving the subcutaneous plane at the posterior aspect of the elbow.

No muscle involvement. No erosion of adjacent cortex. No elbow effusion.

After above study, I&D done which revealed pus. Patient came after 2 wks with purulent discharge again.

Ultrasound

Small amount of fluid with predominantly hypoechoic vascular granulation tissue at the previous abscess site.

There is a reactive node in the anterior elbow. 

Mild irregularity of the olecranon cortex.

Cortical thickening in proximal ulna AP view. No lytic area.

Case Discussion

The first study revealed a subcutaneous abscess involving the posterior aspect of the elbow. I & D was done, which revealed pus.

After 2 weeks the patient presented again with purulent discharge. Histopathology was done this time and revealed tuberculosis.

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