Imaging of extrapulmonary tuberculosis

Area of Science:

• Radiology
• Infectious Diseases
• Public Health

Background:

• Extrapulmonary tuberculosis (EPTB) diagnosis is often difficult, with standard tests yielding inconclusive results.
• Radiographic findings and tuberculin skin tests can support diagnosis but do not exclude EPTB.
• Understanding radiologic manifestations is key to improving EPTB diagnosis.

Purpose of the Study:

• To review and highlight the diverse radiologic findings of extrapulmonary tuberculosis.
• To emphasize the importance of recognizing these patterns for timely diagnosis.
• To underscore the need for high clinical suspicion in at-risk populations.

Main Methods:

• Review of radiologic manifestations in various extrapulmonary sites.
• Discussion of characteristic imaging findings in skeletal, joint, central nervous system, abdominal, genitourinary, lymphatic, and breast tuberculosis.
• Emphasis on differential diagnoses and the role of imaging in guiding further investigation.

Main Results:

• Skeletal tuberculosis commonly affects the spine, femur, tibia, and small bones.
• Joint tuberculosis is typically monoarticular, frequently involving the knee and hip.
• Central nervous system tuberculosis presents as meningitis, tuberculoma, or abscess; abdominal tuberculosis often shows lymphadenopathy; genitourinary tuberculosis is the most common EPTB.
• Lymphatic tuberculosis is common in children (cervical nodes); breast tuberculosis is rare.

Conclusions:

• Radiologic features of EPTB are varied and can mimic other diseases.
• A high index of suspicion is essential, particularly in high-risk groups.
• Definitive diagnosis often requires culture or biopsy, but imaging plays a vital role in suspicion and guidance.