A 40-year-old man presents with slowly increasing pain and restriction of shoulder movement over 8 months, with marked wasting of the deltoid but minimal swelling or effusion. Radiographs show striking periarticular osteoporosis with superficial erosions of the humeral head. Which variant of tuberculosis is this presentation typical of?

• A Caries exuberans
• B Spina ventosa
• C Caries sicca ✓
• D Poncet disease

Explanation

Dry tuberculosis of the shoulder, called caries sicca, is characterised by pain, marked muscle wasting, profound restriction of movement, striking osteoporosis and marginal erosions with conspicuously little effusion or cold abscess formation. This contrasts with the wet exudative form seen more often in the knee and hip. Spina ventosa is expansile tuberculous dactylitis of short tubular bones in children, and Poncet disease is a reactive polyarthritis associated with visceral tuberculosis.

Reference: Tuli's Tuberculosis of the Skeletal System, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.