Oral tuberculosis: unusual radiographic findings

Abstract

Oral tuberculosis and its radiographic findings are not commonly encountered in an oral and maxillofacial radiology practice. Literature has occasional mention of the radiographic findings of oral tuberculosis, which are still ambiguous. When affected, it is manifested majorly in the oral mucosa and rarely in the jaw bones. Here, we report certain unusual radiographic findings of oral tuberculosis which have been rarely mentioned in the literature. Four illustrative cases describe bony resorption, condylar resorption, resorption of the inferior border of the mandible and rarefaction of the alveolar bone as radiographic findings of oral tuberculosis. Follow up of the first case demonstrated regeneration of the condylar head after anti-Kochs therapy was completed, a hitherto unreported phenomenon. The importance of including tuberculosis in the differential diagnosis of some of the unusual radiographic manifestations is emphasized.

Figure 1

Panoramic radiograph showing resorption of the left condylar process in case 1

Figure 2

CT scan showing heterogeneously enhancing mass in left temporomandibular joint region in case 1

Figure 3

Scintigraphic picture revealing uptake in the left ramus and condylar region in case 1

Figure 4

CT-guided fine needle aspiration cycology showing caseating necrosis with epitheloid cells in case 1

Figure 5

A 6 month follow up panoramic radiograph demonstrating evidence of remodelling of the left condylar process in case 1

Figure 6

Panoramic radiograph demonstrating resorption of the head of the left condyle in case 2

Figure 7

Lateral oblique radiograph showing resorption of angle of mandible in case 3

Figure 8

Intraoral periapical radiograph with a gutta percha point through the sinus tract in case 4

Figure 9

Panoramic radiograph showing diffuse area of rarefaction in the mandible near the extraction socket in case 4