Role of MRI in Diagnosing Musculoskeletal Tuberculosis: A Study of Spinal and Joint  Involvement

Aditya Bhargava; Vandana Ahluwalia; Sheikh Tufail Ahmad; Dhairya Rajkumar Malani; Sayeed Anwar Alam; Hassan Unais Mohammed

Aditya Bhargava Junior Resident, Department of Radiodiagnosis, FH Medical College, Agra, India
Vandana Ahluwalia Professor & HOD Radiology, FH Medical College, Agra, India
Sheikh Tufail Ahmad Senior Resident, Department of Radiodiagnosis, FH Medical College, Agra, India
Dhairya Rajkumar Malani Senior Resident, Department of Radiodiagnosis, FH Medical College, Agra, India
Sayeed Anwar Alam Junior Resident, Department of Radiodiagnosis, FH Medical College, Agra, India
Hassan Unais Mohammed Junior Resident, Department of Radiodiagnosis, FH Medical College, Agra, India

Keywords: Musculoskeletal Tuberculosis, Spinal TB, MRI, Diagnostic Accuracy, ROC curve (Receiver Operating Characteristic curve)

Abstract

Introduction: Musculoskeletal tuberculosis (MSK-TB), accounting for 1–3% of all TB cases, remains a significant cause of morbidity, especially in developing countries. Spinal TB (Pott’s disease) and tuberculous arthritis are its most common forms. Early diagnosis is crucial to prevent neurological complications and joint destruction. MRI offers superior soft tissue resolution and has emerged as the modality of choice in early detection and disease characterization.
Materials and Methods: This study included 60 patients with clinically suspected MSK-TB involving the spine or joints. All underwent MRI with T1, T2, STIR, and post-contrast sequences. Imaging findings were assessed for vertebral and joint involvement, abscess formation, and marrow changes. Microbiological or histopathological confirmation was obtained wherever feasible. Sensitivity, specificity, PPV, and NPV of MRI were calculated.
Results: Out of 60 patients, 42 (70%) had spinal TB, and 18 (30%) had articular involvement. The most common MRI features in spinal TB were endplate destruction (88%), paravertebral abscess (83%), and disc involvement (76%). In joint TB, synovial thickening (72%) and joint effusion (61%) were predominant. MRI demonstrated a sensitivity of 92%, specificity of 85%, PPV of 90%, and NPV of 88% compared to confirmatory testing. The ROC curve yielded an AUC of 0.86, indicating excellent diagnostic performance.
Conclusion: MRI is a sensitive and specific tool for diagnosing MSK-TB, enabling early detection of spinal and joint involvement. It should be considered the first-line imaging modality in suspected cases for timely diagnosis and management.

How to cite this article:
Bhargava A, Ahluwalia V, Ahmad S T, Malani D R, Alam S A, Mohammed H U. Role of MRI in Diagnosing Musculoskeletal Tuberculosis: A Study of Spinal and Joint Involvement. J Commun Dis.
2025;57(2):126-130.

DOI: https://doi.org/10.24321/0019.5138.202547

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