PMC6344172_01
Magnetic resonance imaging (MRI) showing the destruction of the tibial bone in the proximal region. MRI = magnetic resonance imaging.
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F1
In magnetic resonance imaging (MRI), compatible chronic granulomatous osteomyelitis lesion was detected, (Fig. 1).
Antero-posterior of thorax of the patient with images suggestive of bronchial wing thickening secondary to inflammatory process.
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F2
Chest X-ray was performed and it ruled out lung compromise (Fig. 2).
Photomicrograph showing fragments of destroyed residual bone and giant Langerhans-type cell within granuloma.
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F3
Biopsy of the bone was performed obtaining a culture with histopathological characteristics suggestive of Mycobacterium tuberculosis (Fig. 3).
PMC6344172_02
X-ray of the left lower extremity with the presence of a large lytic lesion involving the internal condyle of distal epiphysis of the left femur with preserved cortical edges in the boarder of the lesion.
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F4
The X-ray of the left low limb depicted a large lytic lesion, compromising the internal condyle of the distal epiphysis of the left femur, with conserved cortical edges in the border of the lesion (Fig. 4).
High resolution computed tomography (CT) of left parahilar ganglionic growth of 13 to 8 mm and the presence of a 2 mm nodular lesion located in the left lower lobe at the basal level suggestive of calcified granuloma. CT = computed tomography.
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F5
On suspecting osteitis secondary to Tuberculosis, it was decided to start a comprehensive approach or procedure based on the following: lumbar radiography without apparent alterations; lung radiography with the presence of 2 bilateral radiopaque lesions in pulmonary hila, suggestive of calcified nodule without another apparent alteration of the pulmonary parenchyma (Fig. 5); the parent's radiographies were normal; high resolution computed tomography (CT) of lung of the patient with report of left perihilar ganglionic growth of 13 to 8 mm and presence of a 2 mm nodular lesion on the left lower lobe at the basal level, suggestive of calcified granuloma.
PMC6344172_03