Atypical chest wall pain: paravertebral tuberculosis mimicking costochondritis

This case describes a woman in her 30s presenting with a 2 month history of thoracic pain, initially suspected to be costochondritis. The pain was unresponsive to conservative management, and imaging revealed a paravertebral mass at the T6–T7 level. The differential diagnosis included malignancy, sarcoma and tuberculosis (TB). A positive QuantiFERON-TB Gold test suggested TB exposure, before a biopsy subsequently confirmed spinal TB. She was started on quadruple anti-tuberculosis therapy and showed significant clinical improvement. This case emphasises the importance of considering TB in the differential diagnosis of costochondritis, particularly in recalcitrant cases.