Said Ammaarah, Balachandar Ramya, van Vucht Niels
Department of Radiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
BJR Case Rep. 2022 Feb 21;8(3):20210079. doi: 10.1259/bjrcr.20210079. eCollection 2022 Sep.
Tuberculosis is commonly thought of as a disease of the past or a disease of the developing world and immunocompromised populations. Resurgence in non-endemic populations has been trending in recent years. Although musculoskeletal manifestation of tuberculosis is less common-it has insidious onset and it is an indolent process, which in advanced stages can present with extensive pathology and severe morbidity. Diagnosis is often made by a combination of clinical features and imaging findings to initiate early treatment and to reduce complications such as vertebral collapse and cord compression. It is therefore vital for radiologists to be aware of imaging features and unusual presentations related to this destructive disease. This case report illustrates an unusual presentation in a young immunocompetent patient who presented with palpable neck masses and was later found to have extensive multilevel tuberculous spondylodiscitis. The salient features of this uncommon but debilitating disease are discussed and learning points highlighted.
结核病通常被认为是一种过去的疾病,或是发展中国家及免疫功能低下人群易患的疾病。近年来,非地方性人群中的结核病有所抬头。尽管结核病的肌肉骨骼表现较为少见——其起病隐匿,进展缓慢,在晚期可出现广泛病变并导致严重发病情况。诊断通常依靠临床特征与影像学表现相结合,以便尽早开始治疗并减少诸如椎体塌陷和脊髓受压等并发症。因此,放射科医生了解这种破坏性疾病的影像学特征和不寻常表现至关重要。本病例报告展示了一名免疫功能正常的年轻患者的不寻常表现,该患者出现可触及的颈部肿块,后来被发现患有广泛的多节段结核性脊椎间盘炎。本文讨论了这种罕见但使人衰弱的疾病的显著特征,并突出了学习要点。