Sternal tuberculosis

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Left sternoclavicular region pain for 1 month. No trauma. Immunocompromised status. Past history of treatment for abdominal and spinal tuberculosis.

Patient Data

Age: 45 years
Gender: Male
x-ray

No bony or pleuro-parenchymal pathology noted.

ultrasound

A well-defined irregular hypoechoic area is noted abutting left side of manubrium of sternum, anteriorly.  It involves lower end of sternal head of left sternocleidomastoid and sternal head of left pectoralis muscle. Size about 26 x 25 x 10 mm. No mobile echoes could be seen. Erosion is noted in the underlying cortex of manubrium. Local hypervascularity is noted.

Sterno-mandibular joint - Normal. Sterno-calvicular joint - normal. No distension of joint calpsule. 1st costochondral junction -  normal.

Case Discussion

With clinical background, ultrasound features favored tuberculous etiology.

FNA was done. AFB stain  - positive.

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