9.2 Chest radiography

In the first few months of treatment, the patient’s chest radiograph may appear unchanged or show only slight improvement. Although there are no formal recommendations on this, it is prudent to undertake CXR at baseline, at the end of the second month of treatment and at the end of treatment, to document progress and to use for comparison if the patient’s clinical condition changes at any time after the achievement of treatment success (91). A chest radiograph at the end of treatment is also useful to optimally manage TB pulmonary sequelae after treatment (91).

For extrapulmonary TB (in particular TB of the bone or joint), both radiographic examination and computed tomography (CT) can provide information on the evolution of the disease. However, some changes detected by CXR may never return to baseline; hence, the response often needs to be evaluated based on both clinical and radiographic findings. In contrast with pulmonary TB treatment, it is difficult to define what constitutes a cure in extrapulmonary TB.

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