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[Multifocal bone tuberculosis: apropos of a case]

M Moujtahid1, B Essadki, A Lamine

  • 1Service de Traumatologie-Orthopédie (Aile 4), CHU Ibn Rochd, Casablanca, Maroc.

Revue De Chirurgie Orthopedique Et Reparatrice De L'Appareil Moteur
|January 1, 1995
PubMed
Summary

Multifocal bone tuberculosis is a rare condition, particularly in young adults of black race. Early diagnosis and antibiotic treatment are crucial for recovery, with shorter treatment protocols showing success.

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Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Radiology

Background:

  • Tuberculosis of the bone (osseous tuberculosis) is uncommon, accounting for 10-20% of all tuberculosis cases.
  • Multifocal bone tuberculosis is exceptionally rare, representing less than 5% of osseous tuberculosis cases, even in endemic regions.

Observation:

  • A 34-year-old Black Moroccan woman presented with a year of scapular pain, weight loss, and a palpable mass near the sacroiliac joint.
  • Radiological assessment revealed lytic lesions in the humerus, iliopubis, ischium, and iliac wing.
  • A bone scan identified additional tuberculosis sites in the lumbar vertebra and rib.

Findings:

  • Histological examination confirmed caseo-follicular tuberculosis of the humerus.
  • The patient was diagnosed with multifocal bone tuberculosis involving seven distinct skeletal sites.

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  • Treatment involved a 6-month antibiotic regimen and abscess drainage.

    • Implications:

    • Multifocal bone tuberculosis predominantly affects young Black adults, often presenting with progressive symptoms and fistulas.
    • Radiographic findings are non-specific, characterized by geodic lesions with osteocondensation.
    • Diagnosis relies on histological confirmation of peripheral bone lesions, and early, specific antibiotic therapy ensures recovery.