To illustrate the various patterns of skeletal tuberculosis on imaging modalities with emphasis on MR imaging.
To discuss the diagnostic features of skeletal tuberculosis at various sites.
To illustrate the patterns of multifocal skeletal tuberculosis and discuss the differential diagnosis.
Extra-pulmonary tuberculosis occurs in 20% cases of tuberculosis with musculoskeletal tuberculosis occurring in 1-3% of cases.
Spine is the most common site of skeletal tuberculosis accounting for 50% cases of skeletal tuberculosis followed by knee or hip in 30% cases.
and sacroiliac joint are rarer sites.
1.Tubercular arthritis 2.
Osteomyelitis 3.Tenosynovitis and bursitis 4.Pyomyositis.
Multifocalskeletal tuberculosis is an even rarer entity accounting for 10% of total cases of skeletal tuberculosis and should suggest an immunocompromised status of the patient.
Imaging findings OR Procedure details
Patterns of spinal Involvement : Spondylitis and Spondylodiscitis ,
Discal sparing ,
posterior elements involvement .
Various forms can be paradiscal ,
subligamentous and neural arch tuberculosis.
Tubercular osteomyelitis : Difficult to distinguish from other causes of osteomyelitis.
Tubercular arthritis : Characteristic findings like Phemister’s triad,
late stages fibrous ankylosis can occur.
Tenosynovitis and bursitis:Compound palmar ganglion characterized by a swelling in the distal part of volar aspect of wrist and communicating with another swelling over palm across the flexor retinaculum.
Skeletal tuberculosis has an extensive spectrum of clinical and imaging manifestations ,
can virtually involve any bone ,
joint or soft tissues.
Imaging especially MRI has an important role in early detection and characterization of the disease at all sites and is the most preferred imaging modality.
Sonography is useful in superficial locations like wrist and ankle to look for taenosynovitis and bursitis.
Sonology can be used in guidance for therapeutic as well as diagnostic aspirations.
Due to the variable appearance of the disease particularly...
Dr Chandan Kakkar
Department of Radiodiagnosis and Imaging
Kasturba Medical College and Hospital
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Tuberculosis of the spine.
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