Abstract
The objective of this review is to present the imaging findings of skeletal tuberculosis in children. The incidence of tuberculosis is increasing and skeletal tuberculosis accounts for 10–20% of all extra-pulmonary cases. The most common manifestations of skeletal tuberculosis in children are spondylitis, arthritis and osteomyelitis. Tuberculous spondylitis involves the intervertebral disc only late in the disease. Subligamentous spread of the infection may lead to multiple levels of vertebral body involvement that may either be continuous or skipped. Extension of the disease into the paravertebral or extra-dural space may occur. Tuberculous arthritis usually occurs as a result of metaphyseal spread to the joint. Tuberculous osteomyelitis may appear as cystic, well-defined lesions, infiltrative lesions or spina ventosa. The latter is a term used to describe a form of tuberculous osteomyelitis where underlying bone destruction, overlying periosteal reaction and fusiform expansion of the bone results in cyst-like cavities with diaphyseal expansion. Radiographs are still the mainstay of evaluation of patients with bony lesions. Ultrasonography can detect soft-tissue extension of the bony lesions and guide drainage or biopsy procedures. CT accurately demonstrates bony sclerosis and destruction, especially in areas difficult to assess on radiographs such as the posterior elements of the vertebral body. MRI is the modality of choice in evaluating early marrow involvement and soft-tissue extension of the lesion.
Similar content being viewed by others
References
WHO Report (2003) Global tuberculosis control: surveillance, planning, financing
Rasool MN (2001) Osseous manifestations of tuberculosis in children. J Pediatr Orthop 21:749–755
Morris BS, Varma R, Garg A, et al (2002) Multifocal musculoskeletal tuberculosis in children: appearances on computed tomography. Skeletal Radiol 31:1–8
De Vuyst D, Vanhoenacker F, Gielen J, et al (2003) Imaging features of musculoskeletal tuberculosis. Eur Radiol 13:1809–1819
Moore SL, Rafii M (2001) Imaging of musculoskeletal and spinal tuberculosis. Radiol Clin North Am 39:329–342
Carty H, Brunnell F, Stringer DA, et al (2004) Imaging children, 2nd edn. Churchill Livingstone (in press)
Desai SS (1994) Early diagnosis of spinal tuberculosis by MRI. J Bone Joint Surg Br 76:863–869
Hoffman EB, Crosier JH, Cremin BJ (1993) Imaging in children with spinal tuberculosis. A comparison of radiography, computed tomography and magnetic resonance imaging. J Bone Joint Surg Br 75:233–239
Andronikou S, Jadwat S, Douis H (2002) Patterns of disease on MRI in 53 children with tuberculous spondylitis and the role of gadolinium. Pediatr Radiol 32:798–805
Loke TK, Ma HT, Chan CS (1997) Magnetic resonance imaging of tuberculous spinal infection. Australas Radiol 41:7–12
Wang MN, Chen WM, Lee KS, et al (1999) Tuberculous osteomyelitis in young children. J Pediatr Orthop 19:151–155
Haygood TM, Williamson SL (1994) Radiographic findings of extremity tuberculosis in childhood: back to the future? Radiographics 14:561–570
Stabler A, Reiser MF (2001) Imaging of spinal infection. Radiol Clin North Am 39:115–135
Sawlani V, Chandra T, Mishra RN, et al (2003) MRI features of tuberculosis of peripheral joints. Clin Radiol 58:755–762
Martini M, Adjrad A, Boudjemaa A (1986) Tuberculous osteomyelitis. A review of 125 cases. Int Orthop 10:201–207
Edeiken J, DePalma AF, Moskowitz H, et al (1963) “Cystic” tuberculosis of bone. Clin Orthop 28:163–168
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Teo, H.E.L., Peh, W.C.G. Skeletal tuberculosis in children. Pediatr Radiol 34, 853–860 (2004). https://doi.org/10.1007/s00247-004-1223-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-004-1223-7