title: Tuberculotic osteomyelitis of rib--a surgical entity.
abstract: Primary tuberculotic osteomyelitis (TBOM) of the rib is rare. We report our experience of seven patients presenting with primary TBOM of rib. Over a period of eight years, otherwise healthy patients presenting with discharging sinus on the chest wall were managed. Patients included four males and three females, aged between 4 and 18 years. Following history and examination, radiological and histological investigations were performed. After confirming osteomyelitis of rib, excision of the sinus tract along with subperiosteal resection of the affected part of the rib was done. Tuberculosis was confirmed on histological examination of the resected specimens. Oral anti-tubercular therapy (ATT) was given for a period of one year. Patients were followed for 5-8 years. The lesion was demonstrable in all the patients on plain X-ray. Histological confirmation of tuberculosis (TB) before surgery could be done in one patient. The anterio-lateral part of the rib was most commonly affected. Mean operative time was 35 min. Mean postoperative hospital stay was four days. There were no wound complications. No recurrence or relapse was seen. Resection of affected part of the rib with the sinus tract followed by oral ATT for one year is an effective modality of treatment for TBOM of rib.
authors: Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Shahadra, Delhi, India. vivekgtbh@gmail.com
authors: Vivek
authors: V
authors: Agrawal
authors: Mohit Kumar
authors: MK
authors: Joshi
authors: Bhupendra Kumar
authors: BK
authors: Jain
authors: Debajyoti
authors: D
authors: Mohanty
authors: Arun
authors: A
authors: Gupta
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000995:Antitubercular Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010019:Osteomyelitis / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D010027:Osteotomy; D012272:Ribs / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000150:complications / Q000382:microbiology / Q000473:pathology / Q000601:surgery*
chemical_list: D000995:Antitubercular Agents