ArticleRadiology case reports2026
Atypical bone lesion of the fifth metatarsal bone in an HIV-positive patient: A challenging radiologic-pathologic correlation of tuberculous osteomyelitis.
Article in Radiology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Musculoskeletal tuberculosis (TB) represents a small fraction of extrapulmonary TB, accounting for only 1%-3% of cases. Involvement of the foot bones is exceedingly rare, particularly in adults, and often mimics neoplastic or pyogenic processes. Early diagnosis is challenging, especially in immunocompromised individuals, where radiologic findings can be atypical. We describe a 66-year-old HIV-positive male (CD4 count 17 cells/μL) who presented with progressive bilateral foot swelling. Radiography revealed a permeative osteolytic lesion with cortical thinning of the left fifth metatarsal bone. Ultrasound identified a complex fluid collection extending into deep soft tissues. MRI demonstrated marrow infiltration, cortical disruption, and an adjacent abscess with peripheral enhancement, raising suspicion for subacute osteomyelitis versus soft-tissue sarcoma. Surgical debridement and partial metatarsal resection were performed. Histopathology showed granulomatous inflammation with caseous necrosis, and cultures confirmed
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