My father is suffering from heel pain (left ankle) with swelling for 1.5 years. He has consulted various orthopedic doctors.First doctor asked him to follow physiotherapy procedures along with pain killers. With no relief we consulted another doctor.He prescribed steroid injection. Initially his pain subsided for 2 months but became very acute post that. We consulted third doctor and he asked us to do Ultra sound. Ultra sound test suggested MRI to rule out marrow oedema.MRI Impression is "Diffuse marrow signal alterations in the calcaneum bone with ill-defined areas of bony erosions & marrow oedema -possibly ?Infective etiology(Tuberculosis to be ruled out). Small Osteochondral erosion in the medica aspect of talar dome."
So, doctor suspected that he has Calcaneal TB and asked him to undergo biopsy. The doctor took 2 samples; from synovial tissue and left calcaneum bone.The AFB stain reports were negative for both samples.Fungal culture was also negative.Histopathology for the synovial tissue reports "Histological features are consistent with granulation tissue with acute on chronic non specific inflammation.Histopathology report of the bone sample suggested that histological features are consistent with Tuberculous osteomyelitis.
Based on this report his doctor started his TB treatment(Isoniaid-600mg,Rifampcin-450mg,Ethambutol-1200mg,Pyrazinamide-750mgx2, B Long).
Later Pyrazinamide was stopped because it caused rashes in body.
The culture report of both samples have come in after 6 weeks; and are negative for Mycobacterium sps.
I am very confused now as to whether it has been correctly diagnosed.