Age / Sex : 53 / M

Chief complaint : weight loss, lethargy

What is the most likely diagnosis to explain the skeletal lesions?


What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer)

Courtesy : 김효진 (Kim, Hyo Jin), 보라매병원 (SMG-SNU Boramae Medical Center)

Skeletal tuberculosis or TB osteomyelitis

Discussion

Findings
1. Penumbra sign at L1 body lesion (precontrast T1WI) and central non-enhancement at Rt. iliac lesion (postcontrast T1FS) suggest intraosseous abscesses.
2. Empyema necessitans (CT axial), patchy consolidation and tree-in-bud signs (CT) suggest active pulmonary tuberculosis.

References
https://doi.org/10.1186/s43055-024-01191-5