Tuberculosis of the ribs

Brown, T.S.

doi:10.1016/s0009-9260(80)80022-5

Cited by 20 publications

(10 citation statements)

References 6 publications

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“…However, there is no agreement about frequency rates of involvement. While most authors report it as rare in living patients (Rechtman, 1929;Leader, 1950;Johnson and Rothstein, 1952;Sinoff and Segal, 1975;Asnis, 1997;Chang et al, 1999) or uncommon (Leader, 1950;Brown, 1980), others say it is more common (Wassersug, 1941;Tatelman and Drouillard, 1953). Described as a destructive lesion in clinical data, such involvement was previously reported as a single and isolated lesion (Wassersug, 1941;Asnis, 1997), but subsequent studies found other TB lesions in these cases (Tatelman and Drouillard, 1953).…”

Section: Differential Diagnosis Of Rib Lesionsmentioning

confidence: 99%

Anatomy of a serial killer: Differential diagnosis of tuberculosis based on rib lesions of adult individuals from the Coimbra identified skeletal collection, Portugal

Santos

Roberts

2005

American J Phys Anthropol

114

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The role of new bone formation on visceral surfaces of ribs in the diagnosis of tuberculosis (TB) in past human populations has been explored by many researchers, using both skeletal remains with known causes of death and archaeological samples. This study focuses, firstly, on adult skeletons from the Coimbra Identified Skeletal Collection in Portugal and investigates the skeletal manifestations of individuals known to have died from TB; secondly, this study focuses on the role of rib lesions in the diagnostic criteria for TB. One hundred and fifty-seven males and 106 females aged between 22-87 years were examined; causes of death were assigned as pulmonary TB, extrapulmonary TB, and pulmonary non-TB; a control group, extrapulmonary non-TB, was selected from the remaining individuals. Of individuals with rib lesions, 85.7% (69/81) had pulmonary or extrapulmonary TB as an assigned cause of death, while 17.8% (16/90) of individuals with rib lesions had a non-TB cause of death. Rib lesions were significantly more common in individuals who had died from TB, although the lesions cannot be considered pathognomonic for TB. In individuals dying from pulmonary TB, ribs in the central part of the rib cage were most affected, at their vertebral ends. The lower part of the rib cage may be a marker for peritoneal TB, and ''corallike'' new bone formation on ribs may be an indicator of neoplastic disease. Further work on rib involvement in TB in clinical contexts, and the study of further documented skeletal collections, are recommended. Am J

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Section: Differential Diagnosis Of Rib Lesionsmentioning

confidence: 99%

Anatomy of a serial killer: Differential diagnosis of tuberculosis based on rib lesions of adult individuals from the Coimbra identified skeletal collection, Portugal

Santos

Roberts

2005

American J Phys Anthropol

114

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“…19 CT can also provide information on the functional state of the lung parenchyma. The diagnosis should be considered in USA immigrants of Asian or African origin who have chest wall abscess and show rib destruction and extrapleural soft tissue masses on CT. 24 Histopathological analysis is indicated when these typical CT findings are observed. A definitive preoperative diagnosis is frequently difficult to obtain since acid-fast bacilli smears or cultures, fine-needle aspiration and polymerase chain reaction (PCR) are often falsely negative.…”

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confidence: 99%

Tuberculous Empyema Presenting as a Persistent Chest Wall Mass: Case Report

Madeo¹,

Patel²,

Gebre³

et al. 2013

GERMS

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Empyema necessitatis is an empyema that spreads outside of the pleural space involving the chest wall. Tuberculosis is the most common cause. It occurs in both immunocompetent and immunocompromised patients. Due to the long latency period and the paucity of symptoms, diagnosis can be challenging. Clinicians must have a high awareness of this disease, especially in patients from endemic regions. The disease is treatable with surgical and medical interventions. Failure to diagnose can lead to grave consequences for both the individual patient and public health. This is particularly true in endemic regions where controlling the spread of TB is challenging. We report a rare presentation of pulmonary tuberculosis in an otherwise healthy 72-year-old USA immigrant from Thailand. He presented with a painless, chronic chest wall swelling with minimal systemic symptoms. Imaging revealed empyema necessitatis. Histopathology could not give a definitive diagnosis because the tissue was too necrotic. Despite negative acid-fast staining, sputum cultures were positive for tuberculosis. The case presentation is followed by a brief review of the current relevant literature. This case highlights the importance of clinical suspicion and increased awareness for this silent but serious infection.

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“…The CT also provides information on the functional state of the lung parenchyma and thoracic cavities, and concomitant diseases, and excludes other inflammatory or tumor lesions [9]. Brown [10] noted that tuberculous abscess of chest wall can be easily diagnosed in endemic geographic areas in cases with a chest wall abscess with rib destruction and an extrapleural soft tissue mass lesion on chest CT. Cho et al [8] classified the CT findings of tuberculous abscess of the chest wall as follows: 1) a lesion confined to the chest wall, 2) a lesion confined to the inner chest wall beneath the ribs and also protruding into the pleural space, 3) a lesion involving most of the chest wall and also protruding into the pleural space. With this classification, they found that more a superficial location of the abscess did not exclude the risk of rib involvement.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of a Tuberculous Abscess of the Chest Wall

Keum

Kim

Park

2012

Korean J Thorac Cardiovasc Surg

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BackgroundTuberculous abscess of the chest wall is a very rare disease. Few articles have reported on it and those that have enrolled few patients. To determine the characteristics of this disease and to suggest an optimal treatment strategy, we reviewed patients treated by surgical management.Materials and MethodsBetween October 1981 and December 2009, 68 patients treated by surgical management for a tuberculous abscess of the chest wall were reviewed retrospectively.ResultsOf 33 men and 35 women, 31 patients had a current or previous history of tuberculosis. The main complaints were chest pain, a palpable mass, pus discharge, and coughing. A preoperative bacteriologic diagnosis was performed in 12 patients. Abscess excision was performed in 54 cases, abscess cavity excision and partial rib resection in 13, and abscess excision and partial sternum and clavicle excision in 1 case. Postoperative wound infection was noted in 16 patients and a secondary operation was performed in 1 patient. Recurrence occurred in 5 patients (7.35%). Reoperation with abscess excision and partial rib resection was performed in all of the 5 cases.ConclusionComplete excision of the abscess and primary closure of the wound with obliteration of space would decrease postoperative complications. Anti-tuberculosis medication may reduce the chance of recurrence.

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Tuberculosis of the ribs

Cited by 20 publications

References 6 publications

Anatomy of a serial killer: Differential diagnosis of tuberculosis based on rib lesions of adult individuals from the Coimbra identified skeletal collection, Portugal

Anatomy of a serial killer: Differential diagnosis of tuberculosis based on rib lesions of adult individuals from the Coimbra identified skeletal collection, Portugal

Tuberculous Empyema Presenting as a Persistent Chest Wall Mass: Case Report

Surgical Treatment of a Tuberculous Abscess of the Chest Wall

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