Tuberculosis of calcaneus: Assessing treatment response by Tc-99m MDP scintigraphy

Tuberculosis of the calcaneus is a rare entity. Its incidence is reported to be nearly 1% to 2% of all cases of osteoarticular tuberculosis. Because of the low index of suspicion, it is usually diagnosed late. It occurs mostly as a result of hematogenous spread from a primary focus elsewhere in the body. We present a case of a swelling and discharging sinus of the heel in a young adult male. On histopathology, the lesion was diagnosed to be tuberculous in origin. After a standard regimen of multidrug antitubercular treatment, the discharging sinus healed with no further complaints. Scintigraphic imaging of the calcaneal lesion, both pre- and postantitubercular treatment, is presented.