Characteristic radiographic features of osteoarticular TB

Characteristic radiographic features of osteoarticular TB

No pathognomonic radiographic signs of TB exist. However, several signs may be helpful:

  • Spine
    • Narrowing of joint space with vertebral collapse (vertebra plana)
    • Anterior vertebral scalloping and soft tissue swelling (paravertebral abscess)
    • Extensive vertebral destruction with relative preservation of disc space 
  • Peripheral joint
    • Soft tissue swelling with effusion
  • Phemisteri triad
    • Juxtaarticular osteoporosis
    • Peripheral subchondral osseous erosions
    • Articular destructive lesions with little periosteal reaction
    • Joint space narrowing occurs as a late finding
  • Osteomyelitis
    • Lytic lesion with lack of periosteal reaction
  • Dactylitis (mainly children)
    • Ballooned-out lytic appearance of a short bone of the hand with lack of periosteal reaction (spina ventosa)
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