Imaging features of musculoskeletal tuberculosis. Eur Radiol

University of Antwerp, Antwerpen, Flemish, Belgium
European Radiology (Impact Factor: 4.01). 09/2003; 13(8):1809-19. DOI: 10.1007/s00330-002-1609-6
Source: PubMed


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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    • "Our significance of this study is to report it and to alarm the musculoskeletal infection of none-tuberculosis Mycobacterium. It has a similar pattern of presentation to osteomyelitis caused by tuberculous mycobacteria, including a chronic lapse in symptoms, lack of bone tissue near the joint, and swelling of the soft tissues[8]. Also there is growing incidence of procedure related-infection due to increased frequency of invasive injections in pain clinics or oriental clinics[9]. "

    Full-text · Article · Jan 2015 · Journal of Tuberculosis Research
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    • "Radiological features of musculoskeletal TB are non-specific, but may include bone marrow edema, osteoporosis or lytic lesions [8] [9]. The surrounding tissue may show synovitis, joint effusions, tenosynovitis, soft tissue collections, or myositis [8] [9]. The affected bone appears expanded on the X-ray with lytic lesions in the middle (as seen in the present case) and subperiosteal new bone formation along the involved bone. "
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    ABSTRACT: Metacarpal tuberculosis is a rare presentation of the disease; it represents only 1% of all bone sites. The following report documents the case of a 28-year-old female who sought a consultation for a painful right hand following an injury. Radiographs showed a fracture of the distal fifth metacarpal through a lytic lesion. Histology of a biopsy specimen revealed granulomas with caseous necrosis, specific to tuberculosis. The patient experienced a complete recovery with anti-tubercular treatment. This case of an unusual presentation of isolated metacarpal tuberculosis was reported with the intention of highlighting the rarity of this location. It is therefore imperative to bear in mind the possibility of such atypical presentations of tuberculosis when making a rapid and correct diagnosis and prescribing adequate treatment.
    Preview · Article · Dec 2012 · International Journal of Mycobacteriology
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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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    ABSTRACT: Osseous ankylosis of large joints that occurs secondary to infection is rarely described in developed countries, thanks to diagnostic techniques that allow early detection and treatment of the underlying infection. Evidence of the natural history and progression of the disease is now primarily studied through the observation and analysis of osteoarcheological specimens, and medical reports or books dating from the pre-antibiotic era. This report illustrates several cases where modern medical imaging techniques and ancient medical literature were successfully interpreted to diagnose rare, advanced-stage tuberculous alterations in osteoarcheological specimens. Two skeletons from the Bátmonostor cemetery (Hungary) demonstrate complete unilateral ankylosis of the knee. Macroscopic and radiographic examinations were undertaken to assess the extent of skeletal changes and determine their cause. Data obtained from computed tomography (CT) were constructed in 2D and 3D. The 2D CT images revealed cavities involving both the metaphyses and the epiphyses. The 3D reconstructions allowed us to reconstruct the more precise volumetric morphology of the circumscribed lytic lesions, as well as clear ‘image-mirror’ lacunar volumes. On the basis of the macroscopic and radiological analyses, extra-spinal tuberculous infection seems to have been the most probable etiology of these two cases.
    Full-text · Article · Nov 2012 · International Journal of Osteoarchaeology
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