Condensed Imaging Review of Thoracic Tuberculosis

Tuberculosis (TB) remains a challenging global health issue and is considered the leading cause of death from infectious disease. Imaging plays a pivotal role in the diagnosis and management of tuberculosis. This review aims to provide a comprehensive overview of the disease mechanisms and associated radiologic features in active thoracic TB, including dissemination routes, covering pulmonary and extrapulmonary thoracic TB (lymph node, pleural, cardiovascular, and musculoskeletal involvement). We highlight TB complications, diagnostic challenges including post-tuberculous lung disease, imaging correlations with sputum smear positivity, and diagnostic mimics. The review emphasises special clinical scenarios that may pose diagnostic challenges, such as immunocompromised patients with human immunodeficiency virus infection, organ transplantation, and autoimmune disorders treated with biological agents, and drug-resistant TB. We discuss the imaging modalities used in the assessment of thoracic TB and the radiographic monitoring recommendations. A good understanding and recognition of the whole spectrum of disease patterns is crucial for individual patient care as well as for controlling TB spread in the community.