MRI of Musculoskeletal Extraspinal Tuberculosis

Soler, Rafaela; Rodrı́guez, Esther; Remuiñán, Carmen; Santos, Marta

doi:10.1097/00004728-200103000-00004

Cited by 45 publications

(36 citation statements)

References 19 publications

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“…It is the least frequent location of extraspinal musculoskeletal tuberculosis (TB) reported in literature [23].…”

Section: Introductionmentioning

confidence: 99%

Tuberculous Pyomyositis of Forearm Muscles

Narang¹

2008

Hand (New York, N,Y.)

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Tuberculous pyomyositis is a rare entity reported in literature. The presented case reports the occurrence of such a lesion in forearm muscles, without any bony involvement. The ambiguity in its diagnosis led to inadequate management by the primary care physician. Clinical suspicion, positive tuberculin test, culture of acidfast bacilli, 'effective drainage', and timely anti-tubercular chemotherapy ultimately resulted in a good clinical recovery. This case has been presented to increase the awareness about the existence of such an entity in clinical practice, thereby influencing its workup and the possible modes of management.

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“…It is the least frequent location of extraspinal musculoskeletal tuberculosis (TB) reported in literature [23].…”

Section: Introductionmentioning

confidence: 99%

Tuberculous Pyomyositis of Forearm Muscles

Narang¹

2008

Hand (New York, N,Y.)

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“…A diferencia de la osteomielitis piógena, la tuberculosa no respeta los márgenes articulares y a veces el único hallazgo es una lesión lítica solitaria que puede imitar una neoplasia. El diagnóstico diferencial puede ser muy amplio, y a menudo incluye la osteomielitis piógena crónica, el tumor óseo primario, las metástasis secundarias, las enfermedades granulomatosas por hongos y la artritis inflamatoria, entre otras (27,28).…”

Section: Discussionunclassified

Diagnóstico genotípico y fenotípico de tuberculosis ósea y miliar en un paciente VIH positivo en Bogotá, Colombia

et al. 2014

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“…Pyomyositis is the term used to describe a bacterial infection of skeletal muscle with formation of an abscess. Tuberculous pyomyositis is the least frequent location of extraspinal tuberculosis [22]. Isolated pyomyositis without a coexistent active tuberculous lesion, especially in immunocompetent patients, may be considered even more rare as it usually is an extension of the abscess resulting from involvement of underlying or adjacent structures rather than by primary infection, lymphatic or hematogenous spread [4].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

“…Tuberculous pyomyositis occurs more frequently in immunocompromised patients with HIV infection, chronic renal failure, and those receiving cancer chemotherapy or corticosteroids [4,11,14,15,19]. Early diagnosis may be made using MR scans as MRI is superior to ultrasound or CT for detection and characterization of these lesions [1,6,16,21,22]. The small areas of relatively low signal intensity in the abscess on T2-weighted images represent debris and proteinaceous material [22].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

“…Early diagnosis may be made using MR scans as MRI is superior to ultrasound or CT for detection and characterization of these lesions [1,6,16,21,22]. The small areas of relatively low signal intensity in the abscess on T2-weighted images represent debris and proteinaceous material [22]. Fat-suppressed STIR images and peripheral rim enhancement on T1-weighted images after administration of gadolinium contrast may help in differentiating the abscess from other soft tissue masses [6,16].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

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Orthopaedic Case of the Month: A 25-Year-Old Man with a Paramedian Painful Lump over the Anterior Chest Wall

Arora

Sural

Dhal

2011

Clinical Orthopaedics &Amp; Related Research

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A 25-year-old Indian man presented with a swelling of 3-weeks duration over the anterior aspect of his left chest (Fig. 1). The swelling was painful and associated with intermittent low-grade fever. It was insidious in onset and gradually progressive in size. There was no history of cough, hemoptysis, recent weight loss, anorexia, pruritus, seizures, or similar swellings elsewhere in the body. The swelling was not associated with any preceding history of trauma. His medical and family histories were noncontributory. The patient had visited a primary care physician who made the provisional diagnosis of muscular cysticercosis and referred the patient to our institution. On examination, the patient's vital signs were stable and there was no evidence of lymphadenopathy. His physical status was good. Local examination revealed a tender 5-cm 9 3-cm hemispheric fluctuant mass located over the left lower chest wall anteriorly near midline. Its margins were not well defined. Local temperature was increased. The overlying skin was freely mobile and there were no scars or sinuses. On attempted contraction of the upper abdominal muscles, there was no change in the size of the swelling; however, its side-to-side mobility became restricted, suggestive of a swelling arising in the muscle. The rest of the organ systems (respiratory system, abdomen, nervous system) appeared normal on clinical examination.Laboratory examination revealed an increased leukocyte count (13,400/mm 3 ) and the differential count was 60 polymorphonuclear leukocytes, 35 lymphocytes, two monocytes, and three eosinophils. The erythrocyte sedimentation rate (53 mm at the end of the first hour) and C-reactive protein (10.3 mg/L) levels were increased. The sputum examination was negative for acid-fast bacilli. Enzyme-linked immunosorbant assay (ELISA) was negative for cysticercosis antibodies. The ELISA test for HIV I and II antibodies was negative. The patient's immune status was normal with no other focus of infection.The patient underwent imaging studies and laboratory tests. Plain radiographs of the chest were normal. Ultrasound, CT, and MRI of the chest were performed.Based on the history, physical examination, and imaging studies, what is the differential diagnosis? Imaging InterpretationUltrasound examination revealed an oval hypoechoic lesion 5 cm 9 3 cm 9 2 cm in the substance of the left rectus abdominis muscle with increased echogenicity of adjacent muscle fibers suggestive of edema; however, there was no evidence of hyperechoic focus (suggestive of calcification or scolex) in the lesion. Doppler examination Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his institution approved the reporting of this case report, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participa...

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MRI of Musculoskeletal Extraspinal Tuberculosis

Abstract: The MR findings for EMT are variable. Although diagnosis is dependent largely on prior presumption and clinical context, MRI provides valuable guidelines in defining the extent of the lesions to select the appropriate treatment and for follow-up of abnormalities.

Cited by 45 publications

References 19 publications

Tuberculous Pyomyositis of Forearm Muscles

Tuberculous Pyomyositis of Forearm Muscles

Diagnóstico genotípico y fenotípico de tuberculosis ósea y miliar en un paciente VIH positivo en Bogotá, Colombia

Orthopaedic Case of the Month: A 25-Year-Old Man with a Paramedian Painful Lump over the Anterior Chest Wall

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