A Prospective Study on Clinico-Radiological & Pathological Correlation in Musculoskeletal Tuberculosis
Abstract
Singh G, Agarwal VK, Narula RK, Somashekarappa T
Background: To analyse how dependable Clinical, Radiological and Pathological features are in establishing a diagnosis of Musculoskeletal Tuberculosis and to identify other pathological conditions mimicking musculoskeletal tuberculosis.
Materials and Methods: The present prospective study include total of 110 patients in the study. All patients were clinical and radiologically examined. Then patient underwent percutaneous biopsy of the involved region and tissue samples were subjected to histopathological examination and CBNAAT for definitive diagnosis of musculoskeletal tuberculosis.
Results: The study includes 110 cases, male preponderance (65.5%) was seen in comparison to females (34.5%). Clinically and radiologically, dorsal spine (35.5%) and lumbar spine (28.2%) were the most common site of involvement. Out of 110 patients, 100 were confirmed as musculoskeletal tuberculosis by histopathology and molecular diagnosis. Histopathology alone could make diagnosis in 92 cases and molecular diagnosis in 100 cases and 10 cases were non-tuberculous in etiology (metastatic deposits of carcinoma in 5 cases, pyogenic spondylodiscitis in 3 cases and primary neoplastic lesion in 2 cases (giant cell tumour and haemangioma).
Conclusion: Musculoskeletal Tuberculosis is a deep seated and paucibacillary condition difficult to diagnose due to inadequate sample. Therefore, multipronged approach by direct smear examination, histopathological examination, molecular diagnosis is required for early diagnosis. Culture is gold standard for diagnosis but can be negative in partially treated cases. CBNAAT is highly sensitive and specific that enables rapid detection of tubercular bacilli but an give false positive results in non-viable bacilli.