Unusual Manifestations of Bone Tuberculosis

Abstract

THE Protean nature of bone tuberculosis, from the clinical, pathological, and roentgenological standpoints, can be gleaned from the modern literature, beginning with Koenig's work in 1884 to the present day. A few years ago, 1920, Jungling, under the term “osteitis tuberculosa multiplex cystica,” called attention to a previously unknown form of this disease involving the short tubular bones of the hands and feet, occurring usually in children, or about the age of puberty. The lesion is, characteristically, a round or ovoid rarefied area, devoid of periosteal reaction or deposits, with practically no adjacent bone condensation and presenting a “cystic” appearance; the neighboring joints are not involved. The diseased bone strongly resembles that of lupus pernio. Several cases with disease of the short tubular bones, resembling spina ventosa, have been reported in patients with lupus pernio, with complete destruction of the terminal phalanges or marked alteration of the bone architecture. Koenig described a...