title: [Skeletal tuberculosis--diagnostic challenges].
abstract: BACKGROUND
  Skeletal tuberculosis is rare in Norway. The diagnosis could be difficult.
  
  
  METHODS
  A Somalian mother and three daughters and a Somalian girl in the neighborhood developed skeletal tuberculosis 4-12 months after arrival in Norway.
  
  
  CONCLUSIONS
  All had pain as their main complaint. Skeletal scintigraphy and MRI were decisive for demonstration of the infectious locus. Three patients had spondylitis, two of them with serious abscesses. Other localisations were the frontal bone, the humerus shaft, the femoral shaft, and the calcaneus. Despite no signs or symptoms of lung tuberculosis, culture of expectorate or bronchial lavage fluid yielded growth of Mycobacterium tuberculosis in four patients. This demonstrates the importance of bronchial material also in extrapulmonary tuberculosis.
authors.affiliation: Barneavdelingen Sykehuset Buskerud, 3004 Drammen. arnt.winsnes@sb-hf.no
authors.forename: Arnt
authors.initials: A
authors.lastname: Winsnes
authors.forename: Dunja
authors.initials: D
authors.lastname: Refsum
authors.forename: Tore
authors.initials: T
authors.lastname: Kalager
authors.forename: Hjørdis
authors.initials: H
authors.lastname: Iveland
authors.forename: Dag Magne
authors.initials: DM
authors.lastname: Solheim
authors.forename: Marianne
authors.initials: M
authors.lastname: Haakonsen
mesh_terms: D000293:Adolescent; D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D005260:Female; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009664:Norway / Q000208:ethnology; D011877:Radionuclide Imaging; D012998:Somalia / Q000208:ethnology; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology