Journal List > J Korean Soc Radiol > v.63(1) > 1086877

Kim, Cho, Kim, Kim, Hyun, and Lee: Multifocal Skeletal Tuberculosis Mimicking Metastasis Involving the Sternum, Lumbar Vertebra, and Sacrum

Abstract

The incidence of multifocal skeletal tuberculosis is very rare and its diagnosis, very difficult because of vague somatic symptoms and non-specific physical and radiologic findings. We report a case of multifocal skeletal tuberculosis mimicking metastasis.

Figures and Tables

Fig. 1

A 50-year-old woman presented with pain and tenderness on the mid anterior chest wall for 1 month.

A. Axial image reveals soft tissue lesion in sternal body with cortical destruction (arrow).
B, C. CT scan shows soft tissue component with osteolytic change involving L1 body and sacrum (arrow).
jksr-63-69-g001
Fig. 2

Bone scintigraphy shows increased uptake in the body of sternum, and sacrum (black arrows).

jksr-63-69-g002
Fig. 3

A-C. CT-PET scan demonstrates strong FDG uptake in the sternum, L1 body, and sacrum (arrow).

jksr-63-69-g003
Fig. 4

A, B. Follow-up CT scan after 4years shows nearly normalized sternal body, L1 body, and sacrum (arrow).

jksr-63-69-g004

References

1. De Backer AI, Vanhoenacker FM, Sanghvi DA. Imaging features of extraaxial musculoskeletal tuberculosis. Indian J Radiol Imaging. 2009; 19:176–186.
2. Marudanayagam A, Gnanadoss JJ. Multifocal skeletal tuberculosis: a report of three cases. Iowa Orthop J. 2006; 26:151–153.
3. Hong L, Wu JG, Ding JG, Wang XY, Zheng MH, Fu RQ, et al. Multifocal skeletal tuberculosis: experience in diagnosis and treatment. Med Mal Infect. 2010; 40:6–11.
4. De Backer AI, Mortelé KJ, Vanhoenacker FM, Parizel PM. Imaging of extraspinal musculoskeletal tuberculosis. Eur J Radiol. 2006; 57:119–130.
5. Yilmaz MH, Kantarci F, Mihmanli I, Kanberoglu K. Multifocal skeletal tuberculosis. South Med J. 2004; 97:785–787.
6. Gelal F, Sabah D, Doğan R, Avci A. Multifocal Skeletal Tuberculosis involving the lumbar spine and a sacroiliac joint: MR imging findings. Diagn Interv Radiol. 2006; 12:139–141.
7. Shah J, Patkar D, Parikh B, Parmar H, Varma R, Patankar T, et al. Tuberculosis of the sternum and clavicle: imaging findings in 15 patients. Skeletal Radiol. 2000; 29:447–453.
8. Resnick D, Kransdorf MJ. Bone and joint imaging. 3rd ed. Philadelphia: Saunders;2005. p. 603–1419.
9. Morris BS, Varma R, Garg A, Awasthi M, Maheshwari M. Multifocal musculoskeletal tuberculosis in children: appearances on computed tomography. Skeletal Radiol. 2002; 31:1–8.
10. Mulloy EM. Tuberculosis of the sternum presenting as metastatic disease. Thorax. 1995; 50:1223–1224.
TOOLS
Similar articles