~10-35 % of extra-pulmonary Tb is skeletal Tb, most common form is Pott’s disease (Spondylitis)

Differential for malignancy related bone involvement

-Metastatic disease much more common than primary bone cancer
Mnemonic for cancers that  go to bone: BLT + Mayo and a Kosher Pickle

B=Breast
L=Lung
T=Thyroid
Mayo=Multiple Myeloma
Kosher=Kidney
Pickle=Prostate

Don’t forget about infections!
–Infection (eg: staph aureus osteomyelitis),  histoplasmosis, coccidomycosis, Tb!

Extra-pulmonary Tb-it’s not just in the lungs!

Miliary Tb=clinical disease from hematogenous spread of Mycobacterium Tb, can spread to…

–Lungs- (>50 % of patients with Miliary Tb)
-Lymphatic disease-Tb lymphadenitis
–Bone and joint disease- Pott’s disease, skeletal Tb
-GI disease-TB enteritis, peritonitis or hepatic disease
–CNS-Tb meningitis, tuberculoma
-Genitourinary, adrenal disease-renal papillary disease, adrenal insufficiency
-CV-pericarditis
–Skin-Tb Cutis Miliaris

Tb can spread everywhere, make the diagnosis by biopsy and AFB stain & culture, treatment is with RIPE therapy