The great pretender: Multi-system tuberculosis and pathological fracture masquerading as a severe acute football groin injury ‒ Case study with a 5-year follow-up

Abstract

In this clinical case, a man presented with a groin injury on his dominant side, which he apparently sustained in football (soccer) practice  on the previous day. The man was unable to walk unassisted and had to be transported in a wheelchair. The consulting practitioner grew  suspicious upon finding minimal clinical evidence and nothing notable on the X-ray to suggest a severe acute injury. A subsequent  detailed workup revealed extrapulmonary tuberculosis (EPTB) of the musculoskeletal (MSK) and genitourinary tract (GUT) systems,  complicated by a pathological fracture of the acetabulum, as the cause of the groin injury. Management of the EPTB resolved the  condition with no relapse nor long-term sequelae beyond five years, despite being immunocompromised. We present the clinical case  and a five year follow-up. The case serves as a reminder of the possibility that other conditions may mimic sports injuries and further  illustrates a rare presentation of such a condition.