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Took medication for PTB in x-ray, right sulcus is blunt still. Why is it ?

hi! i'm a 37 year-old working mother ( a teacher). according to the x-ray i had in 2010 i have minimal PTB. i had undergone medication and completed it. but when i ahd the x-ray agin this year 2013, the findings showed that my right sulcus is still blunty. how this can be? i don't understand why that was still the findings.
Asked On : Sat, 6 Apr 2013
Answers:  2 Views:  134
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Pulmonologist 's  Response
Hello Ms Jelmaramirez,

If you have received supervised anti-tubercular treatment for 6 months, then you have nothing to worry in this respect.

Was the initial diagnosis made only on the basis of x-ray chest or any other tests were also performed? If you have both the 2010 and 2013 x-rays with you, then show them to your doctor for comparison. Blunting of sulcus (I understand the sulcus as the angle between right dome of diaphragm and the chest wall) is due to small quantity of fluid or fibrous (scar) tissue in the area.

It is not unusual for some scar tissue to remain in this spot even after a complete course of treatment for tuberculosis. It does not suggest active tubercular infection. Discuss out your doubts with your doctor at your (and his) convenience.

Hope you have got an answer to your query. Thanks for using
Answered: Sat, 6 Apr 2013
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Pulmonologist Dr. Satyadeo Choubey 's  Response
HI Jelmaramirez
Thanks for coming to HCM
probably in 2010 you have got right sided tubercular pleural effusion and as you said you have completed the full course of anti tubercular treatment.
Right sulcus blunting can be due to fluid present in it or due to pleural fibrosis, one of the mechanism by which TB heals.

I will suggest you to go for ultrasonography of the right thorax and if fluid is detected go for guided aspiration and investigations like routine microscopy, pleural fluid protein and LDH, acid fast bacilli staining, culture sensitivity, ADA....
TB will be suggested by the pleural fluid report of lymphocytes > 80%, pleural fluid protein> 5, ADA> 40, stainig usually reveals bacilli in 5% ....

IF on ultrasonography fibrosis is there you need not worry, its not active disease but a healed one......

best wishes and thanks
Answered: Sat, 6 Apr 2013
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