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结核病,一个强大的伪装者:通过影像学揭示肌肉骨骼系统罕见受累部位的病例系列报道

Tuberculosis, a great masquerader: A case series unveiling rare sites of musculoskeletal involvement through imaging.

作者信息

Swarup M Sarthak, Bhatt Shuchi, Rawal Rajesh, Tandon Anupama, Dangwal Saumya

机构信息

Department of Radiology, University College of Medical Sciences and GTB hospital, Delhi, India.

Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.

出版信息

SA J Radiol. 2020 Sep 29;24(1):1919. doi: 10.4102/sajr.v24i1.1919. eCollection 2020.

Abstract

Skeletal tubercular infections that do not involve the spine or large joints are rarely encountered. This case series aims to highlight the importance of imaging in diagnosing skeletal tuberculosis (TB) at uncommon sites in clinically unsuspected patients by demonstrating specific imaging findings. We present the clinical details and imaging findings of seven pathologically confirmed cases of extraspinal skeletal TB. A multimodality imaging approach including radiography, ultrasonography (USG) and computed tomography (CT) scan was used in most cases. The imaging studies revealed an infective soft tissue collection over different sites including the sternoclavicular joint, acromion process, chest wall and temporo-mandibular joint, along with destruction and erosion of the underlying or adjacent bones. In tubercular endemic countries, strong clinical suspicion should be entertained in cases presenting with a soft tissue collection, even around unusual skeletal sites.

摘要

不涉及脊柱或大关节的骨骼结核感染很少见。本病例系列旨在通过展示特定的影像学表现,强调影像学在临床未怀疑的患者中诊断罕见部位骨骼结核(TB)的重要性。我们呈现了7例经病理证实的脊柱外骨骼结核病例的临床细节和影像学表现。大多数病例采用了包括X线摄影、超声检查(USG)和计算机断层扫描(CT)在内的多模态成像方法。影像学研究显示,在不同部位存在感染性软组织肿物,包括胸锁关节、肩峰、胸壁和颞下颌关节,同时伴有其下方或相邻骨骼的破坏和侵蚀。在结核病流行国家,对于出现软组织肿物的病例,即使是在不常见的骨骼部位周围,也应高度怀疑结核病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dac/7564854/66baa2bc3fce/SAJR-24-1919-g001.jpg

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