Multifocal musculoskeletal tuberculosis in children: appearances on computed tomography

Abstract

Three of four children had calvarial lesions, with involvement of the bony orbit in one, and large abscesses were present in the chest wall and the mediastinum of another. Lesions along the dorsal spine were demonstrated in three cases, two of which showed epidural extensions. Bone lesions in the thoracic cage accompanying those in the spine were also seen in two children, one of whom had a solitary destructive focus in a rib distant from the site of vertebral involvement. Bone lesions involving the first metacarpal in one case and the scapular wing in two others are also described. The diagnosis in each of the cases was confirmed by the identification of epitheloid giant cells and caseous necrosis or tubercle bacilli in fine needle aspirates or on tissue culture studies.

Skeletal tuberculosis in children in the Western world: 18 new cases with a review of the literature

“…Table 2 presents a comparison of common sites of infection, total number of cases, and total lesions in some of the previously published case series of pediatric skeletal tuberculosis [3,5,9,10].…”

“…To make an accurate and timely diagnosis, physicians must be aware that skeletal tuberculosis may present simply as bone pain and decreased range of motion in the pediatric population. A good history, Table 2 Comparative representation of common locations of skeletal tuberculosis infections in some previously published series [3,5,9,10] thorough clinical examination, high index of suspicion, laboratory work, radiographs, and tissue biopsy may be invaluable in making the diagnosis of tuberculosis.…”

Multifocal Skeletal Tuberculosis in 2 Immunocompetent Children

“…Osteoarticular tuberculosis is rare and is usually seen in endemic countries 3 . Children between 1 and 10 years old are often affected, constituting 50% of cases, with a higher incidence in boys 4,5 . The multifocal form is exceptional; 1 location is found in 90%-95% of cases.…”

“…Of patients with skeletal tuberculosis, 50% have spine lesions, 30% hip or knee lesions, and 10% sacroiliac lesions 3,7 . Involvement of ribs and sacral ala is unusual and accounts for < 1% of all cases of osteoarticular tuberculosis 5 . The most commonly reported complications are expanding abscesses, spinal cord compression, kyphotic deformity, and spine instability.…”

A 30 Year Old Man with Fever and Indolent Soft Tissue Masses

“…Skeletal tuberculosis accounts for about 10-20% of cases of extra-pulmonary tuberculosis and it accounts for 1-2% of all cases of tuberculosis. The spine is involved in 50% of cases of skeletal tuberculosis (Morris et al, 2002), lumbar and thoracic regions are more often involved, whereas the incidence of cervical involvement is 2-3% (Weaver and Lifeso, 1984). Multifocal lesions are reported in 10-15% of cases in developing countries (Lachenauer et al, 1991;Kumar and Saxena, 1988).…”