Orthopedics · Skeletal Tuberculosis

A 55-year-old man presents with a painless swelling over the right anterior chest wall for 4 months. There is no local warmth. Chest X-ray shows a lesion in the 7th rib with a surrounding soft tissue shadow. Aspiration yields caseous material. Which rib is most commonly involved in skeletal tuberculosis?

  • A First rib
  • B Seventh rib
  • C Fifth rib
  • D Third rib
Correct answer: B. Seventh rib

Explanation

Rib tuberculosis most commonly affects the 5th to 8th ribs, with the 7th rib being the most frequently involved. It presents as a painless chest wall swelling or cold abscess without signs of acute inflammation. The first rib is rarely involved. Diagnosis is confirmed by caseous material on aspiration or biopsy.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

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