Answer IN001

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Extrapulmonary TB

Answer IN001
Answer IN002

Spina ventosa
 

A radiographic appearance of short tubular bones of the hands and feet in patients with tuberculous dactylitis. In this abnormality the bones are expanded and have a cystic quality (Fig.1) and there is absorption of bone bordering the medulla, with a new deposit under the periosteum, resulting in a change that is suggestive of bone being inflated with gas.


Spina ventosa, Fig. 1
AP radiograph of the hand demonstrates soft tissue swelling, bone destruction and bone expansion involving the middle phalanx of the long finger.
 

TUBERCULOSIS OF BONE
(Tuberculous Osteomyelities)

        Tuberculosis of bone as an isolated infection of the bone occurs in the phalanges, metacarpal and metalarsal bones carpal and tarsal bones,  ribs and pubis.

Tuberculous Dactylitis

        Tuberculous Dactylitis occurs in children and young adults. The infection starts in the shaft of the phalanx and causes erosion and gradual destruction of the bone. There is subperiosteal new bone formation and thickening of the bone. This phenomenon is peculiar to the tuberculous infection in the short long bones. The surrounding sofrt tissues also swell up and cold abscess often forms and bursts to form chronic siniuses. The patient presents with a painful spindle shaped swelling of the finger which is called spina ventosa.

        In addition to general treatment and antituberculous chemotherpay local treatment is aimed at early eradiction of the lesion. In the early stage, curetting of the focus is done.

Caries of the Rib

        In the rib, tuberculous infection forms a localised destructive focus with a cold abscess. Excision of the affected segment of the rib is combined with general treatment and antituberculous chemotherapy.

B.C.G Osteomyelitis

        B.C.G. Osteomyelitis is a very rare complication of BCG vaccination. It occurs in children from a few months to a few years after the vaccination. The lesions are localised to the metaphysis or epiphysis of long bones. The condition runs a benign course and the general condition of the patients remains good. Antituberculous chemotherapy and operative curettage are done to promote rapid healing.

Poncet's tubercular rheumatism

        Poncet described cases of polyarthritis resembling rheumatoid occurring in patients with tuberculoisis. When the tuberculous focus is treated, the polyarthritis symptoms disappear.

 

                    
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