Tuberculous Osteomyelitis Mimicking a Lytic Bone Tumor: Report of Two Cases and Literature Review.

Tuberculous osteomyelitis is an uncommon form of tuberculosis (TB); the isolated involvement of the wrist joint is particularly rare. The symptoms and clinical manifestation mimic other conditions; hence, careful diagnosis is required. The authors present two cases of patients presenting with soft tissue mass and a lytic bone lesion. The biopsy revealed granulomatous osteomyelitis. Lesion culture identified Mycobacterium tuberculosis . The authors urge clinicians to include TB as a differential diagnosis when investigating the primary cause of lytic bone lesions, even in the absence of pulmonary symptoms or risk factors of TB infection. The inclusion of mycobacterial cultures when analyzing biopsies of lytic bone lesions is also advised.

Tuberculous Osteomyelitis Mimicking a Lytic Bone Tumor: Report of Two Cases and Literature Review / Osteomielite tuberculosa imitando um tumor ósseo lítico: Relato de dois casos e revisão da literatura

Abstract Tuberculous osteomyelitis is an uncommon form of tuberculosis (TB); the isolated involvement of the wrist joint is particularly rare. The symptoms and clinical manifestation mimic other conditions; hence, careful diagnosis is required. The authors present two cases of patients presenting with soft tissue mass and a lytic bone lesion. The biopsy revealed granulomatous osteomyelitis. Lesion culture identified Mycobacterium tuberculosis. The authors urge clinicians to include TB as a differential diagnosis when investigating the primary cause of lytic bone lesions, even in the absence of pulmonary symptoms or risk factors of TB infection. The inclusion of mycobacterial cultures when analyzing biopsies of lytic bone lesions is also advised.

Resumo A osteomielite tuberculosa é uma forma incomum de tuberculose (TB) e o acometimento isolado da articulação do punho pelo TB é particularmente raro. Os sintomas e a manifestação clínica imitam outras doenças; portanto, um diagnóstico cuidadoso é necessário. Os autores apresentam dois casos de pacientes com massa nas partes moles e lesão óssea lítica. A biópsia revelou osteomielite granulomatosa. A cultura da lesão identificou Mycobacterium tuberculosis. Os autores recomendam que médicos clínicos incluam a TB como um diagnóstico diferencial da causa primária das lesões ósseas líticas, mesmo na ausência de sintomas pulmonares ou fatores de risco de infecção por TB. A inclusão de culturas micobacterianas na análise de biópsias de lesões ósseas líticas também é recomendada.