"Caught by the eye of sound" : epigastric swelling due to xiphisternal tuberculosis

2017
journal article
article
1
dc.abstract.enBACKGROUND: Common causes of an epigastric mass include hepatomegaly, pancreatic pseudocyst and epigastric hernia, less common causes being carcinoma of the stomach or pancreas, whereas diseases of the sternum presenting as an epigastric swelling is extremely uncommon. We report a case of tubercular infection of the sternum located in the xiphoid process resulting in its presentation as an epigastric swelling. CASE REPORT: A 30-year-old immunocompetent woman with complaints of an epigastric swelling and undocumented pyrexia for four months was referred for sonographic evaluation with a clinical suspicion of an incompletely treated liver abscess. The patient was examined with ultrasound, sternal radiographs, CT and MRI. Ultrasound revealed a heterogeneous epigastric collection with linear echogenic components suggestive of bone fragments. These appearances suggested chronic infective osteomyelitis of the xiphoid process of the sternum. Lateral chest radiograph demonstrated lytic destruction of the xiphisternum. Tubercular etiology was considered and further evaluation with Multidetector Computed tomography (MDCT) and Magnetic Resonance Imaging (MRI) demonstrated erosive osteomyelitis of the xiphoid process with enhancing inflammation and collection in the adjoining soft tissue. Ultrasound-guided aspiration, PCR and Amplified Mycobacterium tuberculosis DNA test confirmed tubercular infection. CONCLUSIONS: We report a new case of osteo-articular tuberculosis localized to the xiphisternum, a rare clinical entity with an extremely unusual clinical presentation as an epigastric mass. The role of ultrasound in primary diagnosis and as an interventional diagnostic modality for guided aspiration is highlighted.pl
dc.contributor.authorGrover, Shabnam Bhandaripl
dc.contributor.authorArora, Sumitpl
dc.contributor.authorKumar, Amitpl
dc.contributor.authorGrover, Hemalpl
dc.contributor.authorKatyan, Amitpl
dc.contributor.authorNair, Deepthi Mohanpl
dc.date.accessioned2017-02-28T07:52:13Z
dc.date.available2017-02-28T07:52:13Z
dc.date.issued2017pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.additionalBibliogr. s. 45pl
dc.description.physical41-45pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume82pl
dc.identifier.doi10.12659/PJR.899329pl
dc.identifier.eissn1899-0967pl
dc.identifier.issn1733-134Xpl
dc.identifier.urihttp://ruj.uj.edu.pl/xmlui/handle/item/38933
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 3.0 Polska*
dc.rights.licenceCC-BY-NC-ND
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/pl/legalcode*
dc.share.typeotwarte czasopismo
dc.subject.enmagnetic resonance imagingpl
dc.subject.enmultidetector computed tomographypl
dc.subject.ensternumpl
dc.subject.enosteoarticularpl
dc.subject.entuberculosispl
dc.subject.enultrasonographypl
dc.subject.enxiphoid bonepl
dc.subtypeArticlepl
dc.title"Caught by the eye of sound" : epigastric swelling due to xiphisternal tuberculosispl
dc.title.journalPolish Journal of Radiologypl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
BACKGROUND: Common causes of an epigastric mass include hepatomegaly, pancreatic pseudocyst and epigastric hernia, less common causes being carcinoma of the stomach or pancreas, whereas diseases of the sternum presenting as an epigastric swelling is extremely uncommon. We report a case of tubercular infection of the sternum located in the xiphoid process resulting in its presentation as an epigastric swelling. CASE REPORT: A 30-year-old immunocompetent woman with complaints of an epigastric swelling and undocumented pyrexia for four months was referred for sonographic evaluation with a clinical suspicion of an incompletely treated liver abscess. The patient was examined with ultrasound, sternal radiographs, CT and MRI. Ultrasound revealed a heterogeneous epigastric collection with linear echogenic components suggestive of bone fragments. These appearances suggested chronic infective osteomyelitis of the xiphoid process of the sternum. Lateral chest radiograph demonstrated lytic destruction of the xiphisternum. Tubercular etiology was considered and further evaluation with Multidetector Computed tomography (MDCT) and Magnetic Resonance Imaging (MRI) demonstrated erosive osteomyelitis of the xiphoid process with enhancing inflammation and collection in the adjoining soft tissue. Ultrasound-guided aspiration, PCR and Amplified Mycobacterium tuberculosis DNA test confirmed tubercular infection. CONCLUSIONS: We report a new case of osteo-articular tuberculosis localized to the xiphisternum, a rare clinical entity with an extremely unusual clinical presentation as an epigastric mass. The role of ultrasound in primary diagnosis and as an interventional diagnostic modality for guided aspiration is highlighted.
dc.contributor.authorpl
Grover, Shabnam Bhandari
dc.contributor.authorpl
Arora, Sumit
dc.contributor.authorpl
Kumar, Amit
dc.contributor.authorpl
Grover, Hemal
dc.contributor.authorpl
Katyan, Amit
dc.contributor.authorpl
Nair, Deepthi Mohan
dc.date.accessioned
2017-02-28T07:52:13Z
dc.date.available
2017-02-28T07:52:13Z
dc.date.issuedpl
2017
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.additionalpl
Bibliogr. s. 45
dc.description.physicalpl
41-45
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
82
dc.identifier.doipl
10.12659/PJR.899329
dc.identifier.eissnpl
1899-0967
dc.identifier.issnpl
1733-134X
dc.identifier.uri
http://ruj.uj.edu.pl/xmlui/handle/item/38933
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 3.0 Polska
dc.rights.licence
CC-BY-NC-ND
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-nd/3.0/pl/legalcode
dc.share.type
otwarte czasopismo
dc.subject.enpl
magnetic resonance imaging
dc.subject.enpl
multidetector computed tomography
dc.subject.enpl
sternum
dc.subject.enpl
osteoarticular
dc.subject.enpl
tuberculosis
dc.subject.enpl
ultrasonography
dc.subject.enpl
xiphoid bone
dc.subtypepl
Article
dc.titlepl
"Caught by the eye of sound" : epigastric swelling due to xiphisternal tuberculosis
dc.title.journalpl
Polish Journal of Radiology
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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