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Trop Doct 2008;38:239-241
doi:10.1258/td.2008.070413
© 2008 Royal Society of Medicine Press

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Short Reports

Osteomyelitis of the ribs: a strategy for prompt diagnosis and effective management

Debajyoti Mohanty MS   *   Vivek Agrawal MS   *   Bhupendra Kumar Jain MS   *    Richa Gupta MD   {dagger}   Vinita Rathi MD   {ddagger}   Arun Gupta MS   *

* Department of Surgery; {dagger} Department of Pathology; {ddagger} Department of Radiology, University College of Medical Sciences and Guru Teg Bahadur, Hospital, Delhi 110 095, India

Correspondence to: Bhupendra Kumar Jain, KE-92, Kavi Nagar, Ghaziabad 201002, India Email: bhupendrakjain{at}gmail.com

Seven patients were treated for osteomyelitis rib (OR). Discharging sinuses and painful swellings were the presenting symptoms. An initial chest X-ray was unremarkable in all patients. Fine needle aspiration cytology and microscopy of pus did not reveal acid-fast bacillus in any patient. Computerized tomography (CT) of thorax was consistent with the diagnosis of OR in five patients. The patients underwent a subperiosteal excision of the affected part of the ribs or an excision biopsy of the unhealthy granulation tissue. Histopathological diagnosis was consistent with the diagnosis of tuberculosis (TB) OR in six patients. The patients received anti-TB drugs or appropriate antibiotics following surgery. All responded to treatment except one with a non-TB OR, who required further excision of the unhealthy rib ends. Inclusion of a CT of the thorax and an excision biopsy in the diagnostic process facilitates prompt diagnosis and effective management of OR.


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