Radiological Assessment Of Lateral Chest Wall Soft Tissue Thickness In Pulmonary Tuberculosis
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Abstract
Rationale: Weight loss is one of the many symptoms of pulmonary tuberculosis. It can also be found in other wasting diseases like malnutrition, malignancies and HIV infection and AIDS. As a result of this, it is expected that there will be a reduction in the soft tissue thickness of the lateral chest wall in patients with pulmonary tuberculosis and subsequent increase, when treatment has been adequately effected.
Objective: The purpose of this study is to find out if there is any definite reduction in the soft tissue thickness of patients with pulmonary tuberculosis when compared with healthy controls.
Methods: This is a prospective study in which the lateral chest wall soft tissue thickness on chest radiographs of 203 patients (children & adults) with bacteriologically and radiologically proven pulmonary tuberculosis, and nine months post-treatment asymptomatic and bacteriologically negative cases were measured. These were compared with a control group of 50 well-nourished patients, age and sex-matched and who had no clinical and radiological features of pulmonary tuberculosis.
Results: The total mean values of the subcutaneous fat and muscle layer thickness of the pre-treatment tuberculosis cases were 6.89 + 2.6mm and 8.13±2.85mm respectively. The mean values of the subcutaneous fat laver were observed to be significantly lower than the muscle layer in all the age groups (P<0.05). The mean subcutaneous fat and muscle layer thickness of the post-treatment cases were 14.47±6.09mm and 10.73+3.36mm respectively. A significant (P<0.05) increase in thickness was observed in the subcutaneous fat laver over that of the muscle layer in the post-treatment phase. The total mean values of subcutaneous fat and muscle layer thickness in the control group were found to be 16.4 ± 5.6mm and 9.8 2.9mm respectively. The fat layer recorded higher values than the muscle laver. In all, the total mean soft tissue thickness (14.7+5.2)mm in the pre-treatment tuberculosis patients was significantly (P<0.05) lower than in the post treatment (25.2+8.55)mm and control (26.247.6mm).
Conclusions: The clinical implication of this study is that the total soft tissue thickness of the lateral chest wall can be used as an index for monitoring recovery in patients with pulmonary tuberculosis during treatment
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