Imaging in extrapulmonary tuberculosis

- The diagnosis of extrapulmonary tuberculosis (EPTB) remains challenging due to protean clinical manifestations and difficulties in making an accurate diagnosis.
- Advances in imaging technologies now allow for accurate localization of diseased sites and access to obtain biological samples for microbiological, histopathological, and molecular testing.
- Evidence is building for the use of newer imaging modalities for monitoring the response to treatment and relapse.

SummaryTuberculosis (TB) remains a major global public health problem, with 1.5 million deaths annually worldwide. One in five cases of TB present as extrapulmonary TB (EPTB), posing major diagnostic and management challenges. Mycobacterium tuberculosis adapts to a quiescent physiological state and is notable for its complex interaction with the host, producing poorly understood disease states ranging from latent infection to active clinical disease. New tools in the diagnostic armamentarium are urgently required for the rapid diagnosis of TB and monitoring of TB treatments, and to gain new insights into pathogenesis. The typical and atypical imaging features of EPTB are reviewed herein, and the roles of several imaging modalities for the diagnosis and management of EPTB are discussed.