Primary tuberculosis of the clavicle

Area of Science:

• Orthopedics
• Infectious Diseases
• Radiology

Background:

• Tuberculosis of the clavicle is an exceptionally rare manifestation of osteoarticular tuberculosis, accounting for less than 1% of cases.
• The condition presents with nonspecific symptoms, mimicking common bone pathologies, making diagnosis challenging.

Purpose of the Study:

• To describe the clinical features, diagnostic methods, and treatment outcomes of primary tuberculosis of the clavicle.
• To highlight the utility of imaging and laboratory tests in diagnosing this rare condition.

Main Methods:

• Retrospective analysis of 17 patients with primary clavicle tuberculosis.
• Utilized radiography, magnetic resonance imaging (MRI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Mantoux tests, and biopsy with histopathology and cultures for diagnosis.
• Treatment involved 18 months of multidrug antitubercular chemotherapy.

Main Results:

• Radiographic findings included thickening, honeycombing, lytic lesions, osteopenia, or sequestration.
• MRI effectively determined lesion extent and soft tissue involvement.
• Elevated ESR, confirmed diagnosis via biopsy, and successful treatment with chemotherapy were observed.

Conclusions:

• Primary tuberculosis of the clavicle requires a high index of suspicion due to its rarity and nonspecific presentation.
• A combination of clinical evaluation, advanced imaging (MRI), laboratory markers (ESR), and definitive biopsy is crucial for accurate diagnosis.
• Conservative management with multidrug chemotherapy for 18 months yields favorable outcomes and complete recovery.