Citation, DOI & article data
Tuberculous osteomyelitis accounts for ~20% of musculoskeletal tuberculosis 5.
Patients may present with a painful "cold abscess" with a localized mass/swelling +/- draining sinus with erythema or warmth; a low-grade fever may be present 2,4.
There is often a delay between presentation and diagnosis, with a median time to diagnosis reported as 26.4 months 4.
Isolated tuberculosis osteomyelitis without associated tuberculous arthropathy most commonly occurs in the metaphyses of the 1
Plain radiographs can be normal in early infection and when abnormal can show 2,5:
- eccentric lytic lesion with minimal or no periosteal reaction
- a cortical defect may be present
- local osteopaenia
Tuberculous osteomyelitis has a variable appearance with signal characteristics similar to pyogenic osteomyelitis (i.e. low T1, high T2) being reported. One study of 11 cases has shown that some cases may have a slightly higher T1 peripheral rim and low-to-intermediate T2 signal and association with soft tissue abscess 5.
- 1. Burrill J, Williams C, Bain G, Conder G, Hine A, Misra R. Tuberculosis: A Radiologic Review. Radiographics. 2007;27(5):1255-73. doi:10.1148/rg.275065176 - Pubmed
- 2. Vohra R, Kang H, Dogra S, Saggar R, Sharma R. Tuberculous Osteomyelitis. J Bone Joint Surg Br. 1997;79(4):562-6. doi:10.1302/0301-620x.79b4.7618 - Pubmed
- 3. Pigrau-Serrallach C & Rodríguez-Pardo D. Bone and Joint Tuberculosis. Eur Spine J. 2013;22 Suppl 4(S4):556-66. doi:10.1007/s00586-012-2331-y - Pubmed
- 4. Chong S, Herron M, Dolan L et al. TB Osteomyelitis. QJM. 2016;109(11):751-2. doi:10.1093/qjmed/hcw166 - Pubmed
- 5. Sharma P. MR Features of Tuberculous Osteomyelitis. Skeletal Radiol. 2003;32(5):279-85. doi:10.1007/s00256-003-0621-5 - Pubmed