Obligatory medical device diagnostics.
- X-ray of the thorax (radiographic thorax/chest), in two planes (method of choice for persons 16 years and older)
- [Phase 1, onset of infection + phase 2, early tuberculous lesion: exudative reactions/and sharp focus of compression due to pneumonic exudation;
- Phase 3, immune reaction: solid, productive focus;
- Phase 4, cavern formation (cavities created by liquefaction of larger necrosis foci): ring figure of a carverne]
- Other radiological changes: Stripe pattern due to lymphangitis (inflammation of the lymphatics), lightening, infiltrates, ring shadows, pleural effusions (more common in adults than in children), hilar and/or mediastinum (middle pleural space) are widened (only in primary TB), lymph node enlargement, calcifications, and scars
- In severe primary disease: miliary (millet-like) focal spread (focal size 1-5 mm); most severe form: Landouzy sepsis (blood poisoning).
- Differential diagnosis: fresh infection versus old (healed infection):
- Fresh infection: “soft”, blurred infiltrates.
- Old infection: “hard”, calcified infiltrates.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Abdominal ultrasonography (ultrasound examination of abdominal organs) – for suspected extrathoracic TB (e.g., miliary tuberculosis, foci of disease in the lungs and other organs (e.g., liver, spleen))
- Computed tomography (CT) or magnetic resonance imaging (MRI) – in cases of suspected extrathoracic tuberculosis; in cases of abdominal involvement and lymphadenopathy (lymph node enlargement).
- Magnetic resonance imaging (MRI) with contrast medium – in case of suspected manifestation in the musculoskeletal system and CNS.
