- List the musculoskeletal manifestations of tuberculosis (TB) - Describe the multimodality imaging features of musculoskeletal tuberculosis - Recognise the appearances of treated tuberculosis

London has been described as the tuberculosis capital of Europe. Our tertiary referral centre serves boroughs with a high prevelance of tuberculosis, where patients present with advanced disease. Within Europe there has been a rise in the prevelance of tuberculosis and multidrug resistant tuberculosis largely due to migration, socioeconomic factors and immunosuppression. Tuberculosis can present as pulmonary or less commonly extrapulmonary disease. Extrapulmonary manifestations occur in an estimated 25% of patients and less than 5% will present with musculoskeletal disease. Concomitant active pulmonary and musculoskeletal...

Tuberculosis is a major public health consideration worldwide and within Europe. Whilst globally the incidence is falling by 2% each year, the World Health Organisation states this needs to accelerate to 5%. [1] Furthermore, there is an increasing incidence of multi-drug resistant TB, necessitating the requirement for early diagnosis. Extra pulmonary tuberculosis accounts for 25% of disease, with an estimated 1-3% of cases being musculoskeletal. [2] The most common form of skeletal disease is spondylodiscitis, accounting for approximately 50% of musculoskeletal TB. [ 3] Tuberculous...

- There continues to be a significant burden of TB within Europe. There is an increasing prevalence of multi-drug resistant strains, further necessitating the need for prompt diagnosis. - Symptoms, particularly of extra-pulmonary disease can often be indolent non specific, leading to a delay in diagnosis. - Clinical diagnosis requires a combination of clinical presentation, microbiology and imaging. - Whilst there are no radiological pathognomonic features of TB, the radiologist should be aware of extra-pulmonary presentations and imaging findings in order to prevent a delay...

[ 1] World Health Organisation. Tuberculosis [ Internet]. World Health Organisation. September 2018 [ cited 13 May 2019] Available from: https://www.who.int/news-room/fact-sheets/detail/tuberculosis [ 2] Androniku S et al. Musculoskeletal tuberculosis -imaging using low-end and advanced modalities for developing and developed countries. Acta Radiol 2011; 52:430 [ 3] Rivas-Garcia, Sarria-Estrada S, Torrents-Odin C, Casas-Gomila L, Franquet E. Imaging findings of Potts disease. Eur Spine J 2013; 4: 567-578 [4] Up to date. Tuberculosis [ Internet]. Sexton D, McDonald M 2019. [ cited 13 May 2019]. Available from:...