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Tuberculosis of contralateral costo-transverse joints
S M Levine1, E B Marianacci, S V Kattapuram
1Department of Bone and Joint Imaging, Massachusetts General Hospital, Boston, Massachusetts, USA.
Skeletal Radiology
|February 7, 1998
Summary
This case report details an unusual multifocal tuberculosis infection affecting both costo-transverse joints. Increased suspicion for tuberculosis is warranted in endemic areas or with a history of AIDS.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Tuberculosis (TB) is a significant global health concern, primarily affecting the lungs.
- Extrapulmonary tuberculosis (EPTB) represents a smaller proportion of TB cases.
- Multifocal EPTB, particularly involving skeletal structures, is rare.
Observation:
- A rare case of multifocal tuberculosis involving bilateral, symmetric costo-transverse joints is presented.
- This presentation is highly unusual, even in regions with a high prevalence of tuberculosis.
- The costo-transverse joints are rarely sites for tuberculous infection.
Findings:
- The case highlights the potential for tuberculosis to manifest in unusual and widespread patterns within the musculoskeletal system.
- Diagnostic imaging may reveal subtle or extensive involvement of costo-transverse joints.
- Histopathological confirmation is crucial for definitive diagnosis of tuberculous costo-transverse joint involvement.
Implications:
- Clinicians should maintain a high index of suspicion for tuberculosis in patients with unexplained multifocal skeletal infections, especially those from endemic regions or with HIV/AIDS.
- This case underscores the importance of considering tuberculosis in the differential diagnosis of spinal pain and joint abnormalities.
- Further research into the epidemiology and management of multifocal skeletal tuberculosis is warranted.