Osteomielite tuberculosa imitando um tumor ósseo lítico: Relato de dois casos e revisão da literatura

Abstract

Tuberculous osteomyelitis is an uncommon form of tuberculosis (TB); the isolated involvement of the wrist joint is particularly rare. The symptoms and clinical manifestation mimic other conditions; hence, careful diagnosis is required. The authors present two cases of patients presenting with soft tissue mass and a lytic bone lesion. The biopsy revealed granulomatous osteomyelitis. Lesion culture identified Mycobacterium tuberculosis . The authors urge clinicians to include TB as a differential diagnosis when investigating the primary cause of lytic bone lesions, even in the absence of pulmonary symptoms or risk factors of TB infection. The inclusion of mycobacterial cultures when analyzing biopsies of lytic bone lesions is also advised.

Unifocal Tubercular Osteomyelitis of Ulna Diaphysis in a Child: A Case Report

“…TB is known to mimic the symptoms of many other diseases, including various cancers and other infections [ 5 , 13 ]. TB of bone is a rare but important cause of lytic bone lesions and can be easily missed, potentially resulting in ineffective or potentially harmful treatments [ 6 , 15 ]. Benign causes of lytic bone lesion include fibrous lesions like non-ossifying fibroma and fibrous cortical defect, bone-forming tumors such as osteoid osteoma and osteoblastoma, cystic lesions such as unicameral bone cyst and aneurysmal bone cyst, and benign aggressive tumors such as chondromyxoid fibroma, chondroblastoma, giant cell tumor, and Langerhans cell histiocytosis.…”

Tuberculosis of the scaphoid and lunate posing a diagnostic challenge – an orthopaedic surgeon’s perspective

“…However, these non-specific features also occur in other conditions, like benign bone lesions like intraosseous lipoma, chondromyxoid tumours, simple bone cysts, and inflammatory conditions like rheumatoid arthritis or bacterial osteomyelitis. 4 Following a CT scan, the true extent of bony destruction and aberrant macroarchitecture of the bones was appreciated. MRI is highly sensitive for diagnosing osteoarticular infections and is typically the next diagnostic step.…”

“…Only with a high index of suspicion and careful observation, could one appreciate lytic lesions with marginal sclerosis in the scaphoid and lunate. However, these non-specific features also occur in other conditions, like benign bone lesions like intra-osseous lipoma, chondromyxoid tumours, simple bone cysts, and inflammatory conditions like rheumatoid arthritis or bacterial osteomyelitis 4 . Following a CT scan, the true extent of bony destruction and aberrant macro-architecture of the bones was appreciated.…”