Tubercular Osteomyelitis of Clavicle: A Rare Clinico-radiological Diagnostic Dilemma and Master Mimicker
Introduction: Tuberculosis (TB) is one of the most common infections in developing countries. However, TB of the clavicle is a rare entity. Clinical suspicion and early radiological diagnosis of this entity is of utmost importance for patient outcome. Aim: To evaluate and define the role of cross-se...
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JCDR Research and Publications Private Limited
2018-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/11567/28575_CE[Ra]_F(Sh)_PF1(MJ_AnG_SS)_PFA(MJ_AP)_PB(MJ_AP_OM)_PN(SL).pdf |
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| author | Deb Kumar Boruah Arjun Prakash Bidyut Bikash Gogoi Shantiranjan Sanyal Chiranjit Sarkar Suresh Bora |
| author_facet | Deb Kumar Boruah Arjun Prakash Bidyut Bikash Gogoi Shantiranjan Sanyal Chiranjit Sarkar Suresh Bora |
| author_sort | Deb Kumar Boruah |
| collection | DOAJ |
| description | Introduction: Tuberculosis (TB) is one of the most common infections in developing countries. However, TB of the clavicle is a rare entity. Clinical suspicion and early radiological diagnosis of this entity is of utmost importance for patient outcome. Aim: To evaluate and define the role of cross-sectional imaging in tubercular osteomyelitis of clavicle. Materials and Methods: A hospital based prospective study was conducted in a tertiary care centre from June 2015 to December 2016. The study group comprised of pathologically proven eight patients of tubercular clavicular osteomyelitis. CT scans were done in six patients and MRI was done in two patients. Data were presented in terms of percentage, mean and standard deviation. Results: The mean age of presentation of our study population was 37±1.8 years with a male: female ratio of 3:1. Medial 1/3rd of the clavicle was the most commonly affected site. Irregular expansile osteolytic lesions with bony destruction was noted in 5 (62.5%) patients, mild bony erosions in 3 (37.5%) patients, periosteal reaction in 4 (50%) patients, bony sclerosis in 4 (50%) patients and sequestrum formation in 2 (25%) patients. Contiguous affection of adjacent sterno-clavicular joint was seen in 3 (37.5%) patients. Conclusion: Cross-sectional imaging, especially MRI is essential not only in the diagnosis of clavicular tubercular osteomyelitis, but also is important to evaluate the extent of bone marrow involvement, surrounding soft tissue involvement and myositis. This in turn may affect patient management and prognosis, where some of them may require surgical intervention. |
| first_indexed | 2024-12-21T21:37:00Z |
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| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-21T21:37:00Z |
| publishDate | 2018-05-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-fd1bb927948e49acaba1571122e037c32022-12-21T18:49:29ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-05-01125TC09TC1410.7860/JCDR/2018/28575.11567Tubercular Osteomyelitis of Clavicle: A Rare Clinico-radiological Diagnostic Dilemma and Master MimickerDeb Kumar Boruah0Arjun Prakash1Bidyut Bikash Gogoi2Shantiranjan Sanyal3Chiranjit Sarkar4Suresh Bora5Assistant Professor, Department of Radiology, Assam Medical College and Hospital, Dibrugarh, Assam, India.Assistant Professor, Department of Radiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.Junior Resident, Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.Consultant, Department of Radiology, Airedale General Hospital, West Yorkshire, United of Kingdom.Junior Resident, Department of Radiology, Assam Medical College and Hospital, Dibrugarh, Assam, India.Assistant Professor, Department of Orthopaedics, Assam Medical College and Hospital, Dibrugarh, Assam, India.Introduction: Tuberculosis (TB) is one of the most common infections in developing countries. However, TB of the clavicle is a rare entity. Clinical suspicion and early radiological diagnosis of this entity is of utmost importance for patient outcome. Aim: To evaluate and define the role of cross-sectional imaging in tubercular osteomyelitis of clavicle. Materials and Methods: A hospital based prospective study was conducted in a tertiary care centre from June 2015 to December 2016. The study group comprised of pathologically proven eight patients of tubercular clavicular osteomyelitis. CT scans were done in six patients and MRI was done in two patients. Data were presented in terms of percentage, mean and standard deviation. Results: The mean age of presentation of our study population was 37±1.8 years with a male: female ratio of 3:1. Medial 1/3rd of the clavicle was the most commonly affected site. Irregular expansile osteolytic lesions with bony destruction was noted in 5 (62.5%) patients, mild bony erosions in 3 (37.5%) patients, periosteal reaction in 4 (50%) patients, bony sclerosis in 4 (50%) patients and sequestrum formation in 2 (25%) patients. Contiguous affection of adjacent sterno-clavicular joint was seen in 3 (37.5%) patients. Conclusion: Cross-sectional imaging, especially MRI is essential not only in the diagnosis of clavicular tubercular osteomyelitis, but also is important to evaluate the extent of bone marrow involvement, surrounding soft tissue involvement and myositis. This in turn may affect patient management and prognosis, where some of them may require surgical intervention.https://jcdr.net/articles/PDF/11567/28575_CE[Ra]_F(Sh)_PF1(MJ_AnG_SS)_PFA(MJ_AP)_PB(MJ_AP_OM)_PN(SL).pdfcomputed tomographymagnetic resonance imagingtuberculosis |
| spellingShingle | Deb Kumar Boruah Arjun Prakash Bidyut Bikash Gogoi Shantiranjan Sanyal Chiranjit Sarkar Suresh Bora Tubercular Osteomyelitis of Clavicle: A Rare Clinico-radiological Diagnostic Dilemma and Master Mimicker Journal of Clinical and Diagnostic Research computed tomography magnetic resonance imaging tuberculosis |
| title | Tubercular Osteomyelitis of Clavicle: A Rare Clinico-radiological Diagnostic Dilemma and Master Mimicker |
| title_full | Tubercular Osteomyelitis of Clavicle: A Rare Clinico-radiological Diagnostic Dilemma and Master Mimicker |
| title_fullStr | Tubercular Osteomyelitis of Clavicle: A Rare Clinico-radiological Diagnostic Dilemma and Master Mimicker |
| title_full_unstemmed | Tubercular Osteomyelitis of Clavicle: A Rare Clinico-radiological Diagnostic Dilemma and Master Mimicker |
| title_short | Tubercular Osteomyelitis of Clavicle: A Rare Clinico-radiological Diagnostic Dilemma and Master Mimicker |
| title_sort | tubercular osteomyelitis of clavicle a rare clinico radiological diagnostic dilemma and master mimicker |
| topic | computed tomography magnetic resonance imaging tuberculosis |
| url | https://jcdr.net/articles/PDF/11567/28575_CE[Ra]_F(Sh)_PF1(MJ_AnG_SS)_PFA(MJ_AP)_PB(MJ_AP_OM)_PN(SL).pdf |
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