Mycetoma revisited. Incidence of various radiographic signs

To define and quantitate various radiographic signs of mycetoma infection.

A retrospective study of 516 randomly selected patients seen between December 1996 and December 2004 at the Mycetoma Research Centre of Khartoum University, Khartoum, Sudan. All cases were confirmed by clinical examination, initial pretreatment radiographs, and histopathology.

The most common abnormalities in these 516 patients were soft tissue swelling (93%), bone sclerosis (56%), bone cavities (32%), and periosteal reaction (27%). The incidence of bone expansion (22%), extrinsic cortical scalloping (22%), and fanning of the rays in 10% were reported. Osteoporosis was seen in 19%. Only 3% of the patients had normal radiographs.

Maximal scrutiny of radiographs alone by experienced radiologists is vital, as other imaging techniques are not available where mycetoma is prevalent.