Tuberculosis of the sternum and clavicle: imaging findings in 15 patients

Shah, Jeshil R.; Patkar, Deepak; Parikh, Biren; Parmar, Hemant; Varma, Ravi Gopal; Patankar, Tufail; Prasad, Srinivasa R.

doi:10.1007/s002560000207

Cited by 90 publications

(81 citation statements)

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“…Due to overlapping anatomic structures, radiographs are not conclusive in evaluating changes in the clavicle. 11,21,22 Magnetic resonance imaging (MRI) or CT scans, on the other hand, provide far superior images. 11,21,22 Lytic changes are better analyzed in CT scans, especially in the bone window setting, while MRI scans are effective tools in determining the extent of lesions, particularly when there is marrow and soft tissue involvement.…”

Section: Discussionmentioning

confidence: 99%

Appearances are Deceptive: Staphylococcus Superinfection of Clavicular Tuberculous Osteomyelitis

Epperla

Kattamanchi

Fritsche

2014

Clinical Medicine & Research

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A man, aged 25 years, presented with pain, swelling, and drainage from the right clavicular area. He had a past history of abscess at the sternoclavicular joint. The cultures from the drainage site grew methicillin-sensitive Staphylococcus aureus, and he was placed on appropriate antibiotics. As S. aureus infection of the clavicle is often secondary in nature, particularly in adults, a thorough workup was done to identify the underlying cause. Quantiferon gold, done as a part of the workup, came back positive, while the bone cultures grew S. aureus and Mycobacterium tuberculosis. He was placed on 9 months of combination therapy for tuberculosis osteomyelitis with a good clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Appearances are Deceptive: Staphylococcus Superinfection of Clavicular Tuberculous Osteomyelitis

Epperla

Kattamanchi

Fritsche

2014

Clinical Medicine & Research

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“…(2) Other reported cases have also shown a persistent increase in ESR. (4)(5)(6)(7) From a radiological standpoint, sternal TB can present the following patterns of bone destruction: osteolytic lesions; periosteal reaction; enhancement patterns; and soft tissue abscess with or without internal calcium formations. (6) These findings, which are not exclusive to sternal TB, can be found in aggressive infections such as actinomycosis.…”

Section: Discussionmentioning

confidence: 99%

“…(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. (2,4) In the case presented here, there was no increased radiotracer uptake in the sternum or photopenia in the osteolytic lesion, nor were there any other findings consistent with osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

“…(4,5,9) Technetium triphasic scintigraphy has high sensitivity and specificity for the diagnosis of osteomyelitis. (2,4) In the case presented here, there was no increased radiotracer uptake in the sternum or photopenia in the osteolytic lesion, nor were there any other findings consistent with osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

“…(3) Bone and joint involvement accounts for 1-3% of TB cases, and involvement of the sternum accounts for less than 1%. (4,5) Sternal TB predominantly roxine, hydralazine, clonazepam, sertraline, finasteride and doxazosin. Physical examination at admission revealed satisfactory general heath, extremely pale mucosae, an arterial pressure of 130/80 mmHg, a heart rate of 80 bpm, an axillary temperature of 36°C and a respiratory rate of 35 breaths/min.…”

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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