Hugosson C, Nyman R S, Brismar J, Larsson S G, Lindahl S, Lundstedt C
Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Acta Radiol. 1996 Jul;37(4):512-6. doi: 10.1177/02841851960373P216.
To assess frequency, location, and appearance of peripheral osteoarticular and soft-tissue tuberculosis (TB).
Twenty-five of 503 patients with TB had peripheral osteoarticular TB and 5 had soft-tissue TB. Chest radiography, CT, and MR imaging were applied.
The location of the osteoarticular lesion was articular/epiphyseal in 14 patients, articular/metaphyseal in 3, and metaphyseal without joint involvement in 3. Involvement of flat bone was found in 4 patients (5 lesions). The morphologic appearance was similar to that of a lytic tumour in 9 patients (10 lesions) and that of a destructive joint lesion in 16 patients. The soft-tissue TB in all 5 patients presented as an abscess. Twelve patients had a total of 20 additional sites of involvement: chest in 9, abdomen in 4, spine in 4, the neck in 3, and the central nervous system in one patient.
On the basis of radiologic appearance, it can be difficult to differentiate peripheral osteoarticular and soft-tissue TB from other degenerative, inflammatory, or neoplastic disorders, and the importance of a high awareness is stressed in order to reach an early diagnosis.
评估外周骨关节炎和软组织结核（TB）的发生率、部位及表现。
503例结核病患者中，25例患有外周骨关节炎结核，5例患有软组织结核。采用胸部X线摄影、CT和磁共振成像检查。
骨关节炎病变位于关节/骨骺的有14例，关节/干骺端的有3例，干骺端无关节受累的有3例。4例患者（5处病变）发现扁骨受累。9例患者（10处病变）的形态学表现类似于溶骨性肿瘤，16例患者的表现类似于破坏性关节病变。所有5例软组织结核均表现为脓肿。12例患者共有20处其他受累部位：胸部9处，腹部4处，脊柱4处，颈部3处，1例患者累及中枢神经系统。
基于影像学表现，外周骨关节炎和软组织结核可能难以与其他退行性、炎症性或肿瘤性疾病相鉴别，强调提高认识对于早期诊断的重要性。
