Tibial tuberculosis in children with MRI: about a case

The isolated bone localization of tuberculosis is uncommon and occurs mainly in young immunocompromised adults. It can simulate a common germ infection at the beginning or a tumor attack when the evolution is chronic. The authors report the case of a 15-year-old patient with no history of painful and indurated swelling of the upper third of the chronic leg. Conventional radiological investigations made it possible to objectify a superior metaphyseal tibial lytic lesion with a periosteal reaction. MRI revealed a cortical rupture and soft tissue extension in the form of a thick-walled fluid collection, intensely enhancing after gadolinium injection. A surgical biopsy with histological analysis made it possible to retain the diagnosis of tuberculous osteitis. This clinical case highlights the importance of MRI in the exploration of musculoskeletal pathologies.