Case Series

Tuberculosis, a great masquerader: A case series unveiling rare sites of musculoskeletal involvement through imaging

M. Sarthak Swarup, Shuchi Bhatt, Rajesh Rawal, Anupama Tandon, Saumya Dangwal
South African Journal of Radiology | Vol 24, No 1 | a1919 | DOI: https://doi.org/10.4102/sajr.v24i1.1919 | © 2020 M. Sarthak Swarup, Shuchi Bhatt, Rajesh Rawal, Anupama Tandon, Saumya Dangwal | This work is licensed under CC Attribution 4.0
Submitted: 30 May 2020 | Published: 29 September 2020

About the author(s)

M. Sarthak Swarup, Department of Radiology, University College of Medical Sciences and GTB hospital, Delhi, India
Shuchi Bhatt, Department of Radiology, University College of Medical Sciences and GTB hospital, Delhi, India
Rajesh Rawal, Department of Radiology, University College of Medical Sciences and GTB hospital, Delhi, India
Anupama Tandon, Department of Radiology, University College of Medical Sciences and GTB hospital, Delhi, India
Saumya Dangwal, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India


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Abstract

Skeletal tubercular infections that do not involve the spine or large joints are rarely encountered. This case series aims to highlight the importance of imaging in diagnosing skeletal tuberculosis (TB) at uncommon sites in clinically unsuspected patients by demonstrating specific imaging findings. We present the clinical details and imaging findings of seven pathologically confirmed cases of extraspinal skeletal TB. A multimodality imaging approach including radiography, ultrasonography (USG) and computed tomography (CT) scan was used in most cases. The imaging studies revealed an infective soft tissue collection over different sites including the sternoclavicular joint, acromion process, chest wall and temporo-mandibular joint, along with destruction and erosion of the underlying or adjacent bones. In tubercular endemic countries, strong clinical suspicion should be entertained in cases presenting with a soft tissue collection, even around unusual skeletal sites.

Keywords

tuberculosis; chest wall; ultrasonography; computed tomography; sternoclavicular joint.

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