Muskuloskeletal Ultrasound Finding in Disseminated Tuberculosis

Abstract

To describe ultrasound finding of musculoskeletal manifestation in disseminated tuberculosis. This descriptive study was conducted as a public–private mix approach at some least health facilities: Fanayama Community Health Centre, Lukas Goverment Hospital, Stella Maris Hospital, under coordination of South Nias Ministry of Health, Teluk Dalam, North Sumatera during May-July 2015. All patients had musculoskeletal sign and symptoms, in addition to disseminated tuberculosis including peritoneal (dry type) small bowel tuberculosis, chronic cough (lung tuberculosis suspected), neck lymph nodes enlargement and mild fever. The only available portable black and white ultrasound with convex probe 3,5 m Hz was performed on musculoskeletal affected area as well as abdominal ultrasound on tympanic and dullness abdominal pain area according to ‘dam board phenomenon’ of peritoneal dry type – small bowel tuberculosis. N = 2, (9 and 11 y) boys. Musculoskeletal ultrasound finding were thickening of the muscle and synovial of painful affected area in addition to several ovale/round nodular structures (patchy hyper-echoic non-shadowing with an irregular rim of lower echo-density). Small bowel ultrasound showed hypo-peristaltic, irregular thickening heterogenic hypo-echoic of the small bowel wall in addition to similar several ovale/round nodular structures (patchy hyper-echoic non-shadowing with an irregular rim of lower echo-density); loss differentiation of the wall layers, irregular margin and narrowing of the lumen were examined on the dullness pain area. No X-ray available. Follow-up after anti tuberculosis treatment showed improvement both clinically with ultrasound. Ultrasound of musculoskeletal manifestation in disseminated tuberculosis cases had some characteristics.