Computed tomography detection of clinically unsuspected skeletal tuberculosis

Area of Science:

• Radiology
• Infectious Diseases
• Orthopedics

Background:

• Skeletal tuberculosis (STB) can present with subtle or absent clinical signs.
• Computed tomography (CT) is a valuable imaging modality for evaluating various pathologies.
• Early detection of axial STB is crucial for effective management and preventing complications.

Purpose of the Study:

• To determine the frequency of clinically unsuspected axial skeletal tuberculosis (STB).
• To describe the characteristic findings of axial STB on computed tomography (CT).
• To evaluate the utility of bone window CT imaging in diagnosing axial STB.

Main Methods:

• Retrospective analysis of 726 CT scans of the chest, abdomen, and pelvis.
• Inclusion of patients diagnosed with tuberculosis.
• Detailed evaluation of bone window images to identify skeletal involvement.

Main Results:

• Skeletal involvement was identified in 34 patients (4.7%) across 726 CT studies.
• The thoracic spine was the most frequently affected site, with vertebral body involvement in 58% of cases.
• Common findings included intervertebral disc involvement (83%), soft tissue abscess (53%), and epidural extension (39%).

Conclusions:

• Computed tomography (CT) with bone window settings is effective in detecting clinically unsuspected axial skeletal tuberculosis (STB).
• The thoracic spine is a common site for axial STB.
• CT findings such as disc involvement, abscesses, and epidural extension aid in diagnosis.