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Sternal tuberculous osteomyelitis presenting as a pulsatile swelling.

Hari Kishan Boorugu¹, Anugrah Chrispal, Elsa Mary Thomas

¹Department of Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu. drharikishan@gmail.com

The Indian Journal of Tuberculosis

|March 31, 2010

Summary

Primary sternal osteomyelitis, a rare tuberculosis form, can present as a chest wall mass. This case highlights a unique pulsatile swelling caused by sternal bone erosion and mediastinal involvement.

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Area of Science:

Infectious Diseases
Orthopedics
Radiology

Background:

Primary sternal tuberculous osteomyelitis is an exceptionally rare condition.
Tuberculosis (TB) can manifest in diverse ways, affecting various organ systems.
Osteomyelitis, or bone infection, is uncommon in the sternum, especially from TB.

Observation:

A young adult presented with a pulsatile swelling on the anterior chest wall.
Imaging revealed a destructive lesion in the sternum.
The lesion extended into the anterior mediastinum, adjacent to the heart.

Findings:

Computed tomography confirmed a lytic lesion in the sternal body.
The erosion into the mediastinum caused transmitted pulsations, mimicking a vascular anomaly.
The case demonstrates a unique presentation of sternal tuberculosis.

Implications:

This case expands the spectrum of clinical presentations for tuberculosis.
It underscores the importance of considering rare etiologies for chest wall masses.
Early diagnosis and appropriate anti-TB treatment are crucial for managing such cases.