ABSTRACT
The incidence of extrapulmonary tuberculosis (TB) has been rising due to the increasing
number of immunosuppressed patients. Musculoskeletal system accounts for 25% of extrapulmonary
TB. Most of the musculoskeletal TB involves the spine. TB of peripheral joints and
tendons occur infrequently, but if untreated, it can cause serious joint and tendon
destruction as well as spread of the infection to the surrounding bursa, muscle, and
other soft tissues. The diagnosis of TB of joints and tendons is difficult due to
the nonspecific clinical manifestations and imaging features. Concurrent active pulmonary
TB is present in <50% of the patients. A positive chest radiographic finding or a
positive tuberculin test supports the diagnosis, but negative results do not exclude
diagnosis. Although imaging features of TB of joints and tendons are nonspecific,
certain findings such as relatively preserved joint space, juxta-articular osteoporosis,
cold abscesses, para-articular soft tissue calcification, and rice bodies are suggestive
of TB infection. Familiarity with these imaging features can help in making an early
diagnosis and facilitating proper management.
KEYWORDS
Infective tenosynovitis -
Mycobacterium tuberculosis
- septic arthritis - tuberculosis - tuberculous arthritis
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Nuttaya PattamapaspongM.D.
Department of Radiology, Faculty of Medicine, Chiang Mai University
110 Intavaroros Road, Chiang Mai 50200, Thailand
eMail: nuttaya@gmail.com
