Article

Imaging features of musculoskeletal tuberculosis. Eur Radiol

University of Antwerp, Antwerpen, Flemish, Belgium
European Radiology (Impact Factor: 4.34). 09/2003; 13(8):1809-19. DOI: 10.1007/s00330-002-1609-6
Source: PubMed

ABSTRACT The purpose of this article is to review the imaging characteristics of musculoskeletal tuberculosis. Skeletal tuberculosis represents one-third of all cases of tuberculosis occurring in extrapulmonary sites. Hematogenous spread from a distant focus elsewhere in the body is the cornerstone in the understanding of imaging features of musculoskeletal tuberculosis. The most common presentations are tuberculous spondylitis, arthritis, osteomyelitis, and soft tissue involvement. The diagnostic value of the different imaging techniques, which include conventional radiography, CT, and MR imaging, are emphasized. Whereas conventional radiography is the mainstay in the diagnosis of tuberculous arthritis and osteomyelitis, MR imaging may detect associated bone marrow and soft tissue abnormalities. MR imaging is generally accepted as the imaging modality of choice for diagnosis, demonstration of the extent of the disease of tuberculous spondylitis, and soft tissue tuberculosis. Moreover, it may be very helpful in the differential diagnosis with pyogenic spondylodiscitis, as it may easily demonstrate anterior corner destruction, the relative preservation of the intervertebral disk, multilevel involvement with or without skip lesions, and a large soft tissue abscess, as these are all arguments in favor of a tuberculous spondylitis. On the other hand, CT is still superior in the demonstration of calcifications, which are found in chronic tuberculous abscesses.

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    • "The route of infection is usually through the respiratory tract, although infection occasionally occurs through the intestinal tract. Osseous alterations are associated with only 1–3 % of the TB cases (Tuli, 2004; Vanhoenacker et al., 2009). Bone alterations develop slowly after the haematogenous dissemination from the remote septic foci. "
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    • "L'IRM permet d'e ´voquer le diagnostic a ` un stade précoce en précisant la localisation de l'infection, unique ou multiple, son extension osseuse, vertébrale, discale, e ´pidurale ou para vertébrale [7] [9] [10] [12] [13]. L'IRM peut déceler des complications e ´ventuelles (abcès) susceptibles de bénéficier d'une intervention chirurgicale de décompression, ou d'un geste de drainage percutané [8]. "
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