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Osteomyelitis

Tuberculous osteomyelitis

Author: Dariusz Borys, M.D.

Last author update: 1 August 2013

Last staff update: 25 May 2023

Copyright: 2003-2023, PathologyOutlines.com, Inc.

PubMed Search: Tuberculous osteomyelitis[title]

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Table of Contents

Cite this page: Borys D. Tuberculous osteomyelitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/boneTBosteo.html. Accessed June 6th, 2023.

Definition / general

Osteomyelitis - general

Infection of bone (osteitis) or bone marrow space (myelitis) = osteomyelitis
Usually pyogenic, fungal or tubercular
HIV+ patients may be infected by unusual organisms (eg. Mycobacterium avium)
Radiographically may resemble a neoplasm, particularly after antibiotic treatment
Severe osteomyelitis is not associated with grade IV sacral decubitus ulcers in non-septic patients; imaging may be misleading (Arch Pathol Lab Med 2003;127:1599)
May cause secondary AA amyloidosis

Osteomyelitis - tuberculous

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

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