Bone & joints
Osteomyelitis
Tuberculous osteomyelitis
Author: Dariusz Borys, M.D.
Topic Completed: 1 August 2013
Revised: 27 December 2018
Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.
PubMed Search: Tuberculous osteomyelitis[title]
Table of Contents
Definition / general | Clinical features | Sites | Radiology images | Gross images | Microscopic (histologic) images | Differential diagnosisCite this page: Borys D Tuberculous osteomyelitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/boneTBosteo.html. Accessed August 7th, 2020.
Definition / general
- 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
Sites
- Vertebrae, hip, knee, ankle, elbow, wrist
- Usually involves synovium, epiphysis or metaphysis
Radiology images
Contributed by Dr. Mark R. Wick
Cervical vertebrae paraspinal tuberculous abscess MRI
Gross images
Contributed by Dr. Mark R. Wick
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Tubeculous vertebral osteomyelitis (Pott disease)
Microscopic (histologic) images
Contributed by Dr. Mark R. Wick
Differential diagnosis
- Foreign body granuloma post-surgery (Am J Surg Pathol 1997;21:563)
