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Age / Sex : /
Age / Sex: F/20
Chief complaint: Back pain which started about 2 months ago, an aggravated about 2 weeks ago
1) What is your impression?
Two weeks later, you can see the final diagnosis with a brief discussion of this case.
* Send Application Answers to Ja-Young Choi, MD ([email protected])
Courtesy : Kyu-Sung Kwack, MD., Ajou University Hospital
Diagnosis: Multiple cystic tuberculosis of bone (Jungling's disease)
Discussion
Findings:
Multiple well defined osteolytic lesions, some with sclerotic margin Compression fractures at T5, T6 Multiple bone marrow signal alterations at spines
Diagnosis: Tuberculosis
Discussion:
Rare variant of tuberculosis which is more common in children Various terminologies for multiple cystic tuberculosis, including Jüngling's disease (osteitis tuberculosa multplex cystica) and pseudocystic tuberculosis in children Biopsy is usually required to confirm the diagnosis Usually shows good prognosis
1. Child type Usually in the peripheral skeleton Metaphyseal regions of tubular bones Symmetric, no sclerosis
2. Adult type Mainly involving axial skeleton Well defined margins with sclerosis
References:
1. Multiple Cystic Tuberculous Lesions in the Skeleton (Jüngling Disease): A Case Report Spine 2003 Volume 28(8) April, E155-E157
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