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Tuberculosis of the ribs: CT appearance
1Department of Diagnostic Radiology, Seoul National University College of Medicine, South Korea.
Journal of Computer Assisted Tomography
|May 1, 1993
Summary
Tuberculosis of the ribs is a rare inflammatory lesion. CT scans reveal juxtacostal soft tissue masses with specific enhancement patterns, often without significant bone destruction.
Area of Science:
- Radiology
- Infectious Diseases
- Orthopedic Surgery
Background:
- Rib tuberculosis is an uncommon inflammatory condition.
- It is the second most frequent destructive cause of rib lesions, after metastatic neoplasm.
- Clinical presentation varies, including painful masses and chest pain.
Purpose of the Study:
- To retrospectively analyze computed tomography (CT) findings in patients with pathologically proven rib tuberculosis.
- To describe the imaging characteristics and patterns of rib tuberculosis on CT.
- To correlate CT findings with clinical presentation and extent of bone involvement.
Main Methods:
- Retrospective analysis of CT scans from eight patients with 13 pathologically confirmed rib tuberculosis lesions.
- Review of presenting symptoms, location of lesions, and presence of concomitant pulmonary tuberculosis.
- Detailed assessment of CT features, including soft tissue mass characteristics, enhancement patterns, and bone destruction.
Main Results:
- All 13 lesions presented as juxtacostal soft tissue masses with central low attenuation and peripheral rim enhancement (typical of a cold abscess).
- Bone destruction was observed in only 4 of 13 lesions: two osteolytic expansile lesions and two with mild cortical irregularities.
- Lesions were located at the costochondral junction (5), rib shaft (5), sternochondral junction (2), and costovertebral joint (1). Five patients had concurrent pulmonary tuberculosis.
- No direct extension into the lung parenchyma was noted.
Conclusions:
- CT is valuable in diagnosing rib tuberculosis, characterized by juxtacostal soft tissue masses with a 'cold abscess' appearance.
- Bone destruction is infrequent in rib tuberculosis.
- The findings emphasize the importance of considering tuberculosis in the differential diagnosis of rib lesions, especially in patients with pulmonary tuberculosis.