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Tuberculous osteomyelitis

Reviewers: Dariusz Borys, M.D. (see Reviewers page)
Revised: 16 August 2013, last major update June 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.


● Usually young adults or children

Pott's disease:
● Involvement of spine (thoracic/lumbar)
● Extensive necrosis of intervertebral discs with extension into soft tissue
● May produce significant deformities or neurologic deficits
● Difficult to treat

Clinical features

● In US, due to immigrants and immunosuppression
● 1-3% with tuberculosis have bone infection, usually from focus of acute visceral disease, direct extension or lymphatics
● Rarely causes inguinal mass with fluctuant psoas abscess
● In AIDS patients, bone infection usually multifocal
● Advanced cases are associated with cutaneous sinuses, which cause secondary bacterial infections
● Associated with fusion of joint, denudation of cartilage, sequestra of medullary cavity
● Can detect in synovial fluid by culture and examination


● Vertebrae, hip, knee, ankle, elbow, wrist
● Usually involves synovium, epiphysis or metaphysis

Radiology images

Cervical vertebrae paraspinal tuberculous abscess MRI - contributed by Dr. Mark R. Wick

Gross images

Tubeculous vertebral osteomyelitis (Pott disease) - contributed by Dr. Mark R. Wick

Micro images

Contributed by Dr. Mark R. Wick

Differential diagnosis

● Foreign body granuloma post-surgery (Am J Surg Pathol 1997;21:563)

End of Bone > Osteomyelitis > Tuberculous osteomyelitis

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