CT and MRI in tuberculous sternal osteomyelitis

Atasoy, Çetin; Öztekin, Pelin Seher; Özdemır, Nezıh; Sak, Serpil Dizbay; Erden, İlhan; Akyar, Serdar

doi:10.1016/s0899-7071(01)00374-6

Cited by 42 publications

(52 citation statements)

References 8 publications

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“…and Aspergillus sp., the latter being a disease that typically has an abrupt onset and prominent constitutional symptoms. (6) The clinical presentation, including symptoms such as sternal pain and swelling evolving over approximately one year, together with normal chest X-ray findings and an ESR of 48 mm/h, is in accordance with data reported in a case-series study of sternal TB, in which symptoms evolved over a mean of 9 months and the most common (in 81% of the cases) were sternal pain and swelling. (2) In that study, chest X-ray findings were normal in 73% of the cases and ESR was elevated (mean, 67 mm/h) in almost all cases.…”

Section: Discussionsupporting

confidence: 89%

“…(2) Contamination can originate from infected local lymph nodes (contiguous with the lung parenchyma) or due to reactivation of a quiescent focus. (6) The case described here reflects the indolent character of osteoarticular TB, in contrast to that of pyogenic osteomyelitis, caused principally by S. aureus, Pseudomonas aeruginosa, Salmonella sp. and Aspergillus sp., the latter being a disease that typically has an abrupt onset and prominent constitutional symptoms.…”

Section: Discussionmentioning

confidence: 77%

“…(1,2) According to the literature, the definitive diagnosis of sternal TB is based on microbiological evaluation together with histopathological confirmation. (6) Two groups of authors evaluating methods applied in the diagnosis of TB found that the sensitivity and specificity of PCR (90% and 80%, respectively) were similar to those of culture. (11,12) Both groups of authors stated that the quality of the sample and the standardization of the DNA extraction technique are critical factors in the applicability of PCR in the diagnosis of TB in Brazil.…”

Section: Discussionmentioning

confidence: 97%

“…X-ray in the evaluation of bone involvement, it is significantly superior in the evaluation of perilesional soft tissues, mediastinal involvement and pulmonary involvement. (5)(6)(7)(8)(9) Magnetic resonance imaging is a good option for the evaluation of soft tissues and bone lesions, revealing early alterations in the bone marrow, especially at early stages with normal X-ray findings. (4,5,9) Technetium triphasic scintigraphy has high sensitivity and specificity for the diagnosis of osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

“…(13) The principal differential diagnoses are malignancy, sarcoidosis, actinomycosis and fungal infections. (6,7) In the literature, there is no consensus regarding treatment modality, treatment duration or the best treatment regimen. Although early drainage and complete debridement improve cicatrization and prevent recurrence, some authors suggest that conservative treatment with antituberculous drugs be performed and surgical debridement be reserved for chronic cases with structural complications or for cases of treatment failure.…”

Section: Discussionmentioning

confidence: 99%

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Osteomielite esternal por Mycobacterium tuberculosis

et al. 2009

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A 74-year-old white male who was a retired farmer, a nonsmoker and a former drinker presented with a one-year history of chest pain in the suprasternal notch, accompanied by edema and local erythema. His condition had worsened two weeks prior, aggravated by drainage of purulent material from a fistulous lesion. In addition, he reported evening fever, night sweats and weight loss (25 kg) in the last 12 months. The patient was under outpatient follow-up treatment in various sectors of the Santa Maria University Hospital, due to multiple comorbidities: systemic arterial hypertension; heart failure; mitral valve disease; pulmonary arterial hypertension; hypothyroidism; chronic renal failure; nonspecific colitis; and benign prostatic hyperplasia. He was being treated with furosemide, simvastatin, omeprazole, levothy- IntroductionThe extrapulmonary form of TB involving the sternum is quite rare. The most significant risk factor for the disease is open heart surgery.(1) Other risk factors include intravenous drug abuse, blunt thoracic trauma, closed cardiopulmonary resuscitation, subclavian vein catheterization, diabetes mellitus, HIV infection, alcoholism and BCG vaccination.(1) Sternal TB usually affects young adults living in areas where TB is endemic. Since the advent of modern antituberculous therapy, the number of cases of sternal TB has dramatically decreased, there having been fewer than 20 cases reported in the literature since that time.(2) We report the case of a male patient without active pulmonary disease who was under follow-up treatment at a clinical medicine outpatient clinic when he developed sternal TB. Sternal osteomyelitis caused by AbstractWe report the case of a 74-year-old male patient with a one-year history of chest pain in the suprasternal notch associated with erythema, edema and drainage of purulent material from a fistulous lesion. The patient was HIV-negative with no history of TB. A CT scan of the chest showed an osteolytic lesion in the sternum, and a biopsy revealed caseous granuloma, which, in the microbiological evaluation, was negative for fungi and acid-fast bacilli.The diagnosis of sternal osteomyelitis caused by Mycobacterium tuberculosis was confirmed using PCR.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 77%