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Multifocal bone disease in a young patient in India

Multifocal bone disease in a young patient in India
This is a 28-years old with back pain. An MRI shows multiple bone lesions and hence he had a PET/CT done, which showed the same findings – multiple vertebrae and the sacrum. The first diagnosis was metastases, then myeloma and lastly tuberculosis.
Look at the clues. The CT scan shows ill-defined sclerosis with weird shaped osteolytic lesion. The MRI shows T2 low signal with edema. These are highly unusual for metastases or myeloma.
We did a CT guided biopsy with an 18G needle and this shows granulomatous inflammation of mycobacterial etiology.
Tuberculosis is still the commonest cause of multifocal bone lesions in patients below the age of 35 without a known primary neoplasm.
#tuberculosis #petct #ctguidedbiopsy #biopsy #tbspine from Instagram: http://ift.tt/1RAFD5h