Tuberculosis, a great masquerader: A case series unveiling rare sites of musculoskeletal involvement through imaging

Swarup, M. Sarthak; Bhatt, Shuchi; Rawal, Rajesh; Tandon, Anupama; Dangwal, Saumya

doi:10.4102/sajr.v24i1.1919

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…[14][15][16][17] In our patient, the contact history, socioeconomic status, constitutional symptoms, lytic rib lesions, presence of cold abscess, a positive tuberculin skin test, very high erythrocyte-sedimentation rate and positive PCR favoured TB. X-rays are notorious in being normal for the early stages of a disease, 18 as in our patient, who had been evaluated earlier by three providers. CT scans are sensitive in defining bone lesions, and they help They found lesions to be osteolytic and expansile with disrupted or irregular cortices.…”

Section: Discussionmentioning

confidence: 68%

Isolated Tuberculosis of the Ribs in an Immunocompetent Adult

Rajkumar¹

2022

Infectious Diseases

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Skeletal involvement is a frequent site of extrapulmonary tuberculosis, but an isolated disease of the ribs is rare. This case report studied an adult immunocompetent male patient who presented with constitutional symptoms, pain and point tenderness in two ribs. The diagnosis of rib tuberculosis was delayed due to earlier providers not recognizing the condition. Routine chest X-rays performed in the early stages of the disease did not reveal abnormalities, but computed tomography did. The patient had lytic rib lesions and a swelling of the chest wall soft tissue consistent with a cold abscess. Specifically, the scan was significant for the absence of involvement of the lung, pleura, spine and mediastinal lymph nodes. While routine smears and cultures were negative, a polymerase chain reaction test for Mycobacterium tuberculosis performed on a sample of aspirate from the swelling confirmed the diagnosis. The patient responded to anti-tuberculous drug therapy, made a complete recovery without complications or the need for surgery and has now been disease free for 16 years. The patient had no concomitant pulmonary disease and was not immunocompromised. The timely intervention could prevent complications. This case report reviews literature and recent research on rib tuberculosis. If these research findings are replicated in larger studies, it will pave the way for more effective management of this rare condition.

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Section: Discussionmentioning

confidence: 68%

Isolated Tuberculosis of the Ribs in an Immunocompetent Adult

Rajkumar¹

2022

Infectious Diseases

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“…TB affecting the musculoskeletal system is a relatively uncommon medical condition, constituting only 5% of such infections [7][8][9]. Within this category, tuberculosis in the elbow joint is a rare occurrence, accounting for 5% of musculoskeletal TB cases [10,11].…”

Section: Discussionmentioning

confidence: 99%

Exploring the Esoteric: Tuberculosis of the Medial Epicondyle of the Humerus

Soraganvi,

Ram,

Reddy

et al. 2023

Cureus

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Tuberculosis (TB) of the medial epicondyle of the humerus represents a rare etiology of chronic pain, swelling, and restricted mobility of the elbow joint, characterized by a gradual progression of the swelling. The paucity of reported cases in the literature attests to their infrequency. Herein, we present a case that was referred to our department after enduring swelling, restricted movement, and discomfort for a period of one year. The patient underwent a thorough clinical evaluation, followed by debridement, which ultimately resulted in the diagnosis of TB of the medial epicondyle of the humerus. In this ensuing case report, we comprehensively describe the clinical presentation, diagnosis, and treatment approach employed for this uncommon manifestation of TB affecting the elbow joint.

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“…5,6,8 Periarticular osteopenia, marginal erosions and subtle joint space loss are seen with articular involvement and are called the Phemister triad (Figure 12). 5,6,8 A recent case series by Swarap et al, 15 demonstrates atypical sites of musculoskeletal involvement, and emphasises the need for maintaining a high index of suspicion in order to make the correct diagnosis.…”

Section: Musculoskeletalmentioning

confidence: 99%

The silent pandemic in South Africa: Extra-pulmonary tuberculosis from head to heel

Roux

Vlok

2021

South African Journal of Radiology

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Extra-pulmonary tuberculosis (EPTB), caused by Mycobacterium tuberculosis, is the leading cause of communicable disease-related deaths in people with human immunodeficiency virus (HIV) worldwide and in South Africa. Mycobacterium tuberculosis disseminates haematogenously from an active primary lung focus and may affect extra-pulmonary sites in up to 15% of patients. Extra-pulmonary TB may present with a normal chest radiograph, which often causes a significant diagnostic dilemma. This review describes the main sites of involvement in EPTB, which is illustrated by local imaging examples.

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Tuberculosis, a great masquerader: A case series unveiling rare sites of musculoskeletal involvement through imaging

Cited by 4 publications

References 14 publications

Isolated Tuberculosis of the Ribs in an Immunocompetent Adult

Isolated Tuberculosis of the Ribs in an Immunocompetent Adult

Exploring the Esoteric: Tuberculosis of the Medial Epicondyle of the Humerus

The silent pandemic in South Africa: Extra-pulmonary tuberculosis from head to heel

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