• Kamaran Karadakhy Department of Medicine, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.



Tuberculosis, Chest X-Ray, Sulaimani, Iraq



The radiological findings of pulmonary tuberculosis show considerable variations but, in most cases, they are characteristic enough to suggest the diagnosis. Chest X-Ray remains an important tool of screening and diagnosis of the disease. 


The current study aims to describe the radiological findings in patients treated for tuberculosis in DOTS centers in Sulaimani city.


A CXR of a total of 179 patients diagnosed with tuberculosis during 2010-2011 were checked for findings in this analysis. 


The most common finding was infiltration in 127 (71%) cases followed by pleural effusion (18%), opacity (6%) and a cavity in 3% of the patients. Types of lesions were not statistically associated with age or sex. The right lung alone was the most affected side in 47% of cases, left lung in 33% and both lungs in 20% of cases. The lesions involved the upper zone in 69% of cases followed by the lower zone (16%) and the middle zone (15%). The overall mortality of these patients was 4.5%. Older age was a significant factor of death as mortality was 10.6 % in patients aged 65 and over while it was 5.8% in patients aged between 35-65 and zero in younger patients. The middle zone lesions were associated with a statistically higher mortality rate compared to the other zones. 


The study showed that the infiltration was the most common radiological finding, the right lung was most affected, and mortality was higher in older age and middle zone lesions. Evaluation of CXR findings of tuberculosis patients remains important both for diagnosis and follow-up.


World Health Organization, WHO, report (internet). WHO Global Tuberculosis report 2017. Citation.Global tuberculosis report 2017. Geneva: World Health Organization; 2017. Licence: CC BY-NC- SA 3.0 IGO. WHO/HTM/TB/2017.23 available from

Ann N. Leung.State of the Art, Pulmonary Tuberculosis: The Essentials Radiology 1999; 210:307–322- Volume 210. Number 2. DOI:

Mc Adams HP; Erasmus J; Winter JA Radiologic manifestations of pulmonary tuberculosis. Radiol Clin North Am. 1995; 33(4):655-78 : DOI:

J Andreu, J Caceres ,E Pallisa, M Martinez-Rodriguez Radiological manifestations of pulmonary tuberculosis; Europian Journal of Radiology, August 2004 Volume 51, Issue 2, 139/149. DOI:

Tara M Catanzaro. Primary Tuberculosis Imaging(internet). Medscape.Nov 29, 2016.

World Health Organization, WHO, report (internet). WHO, CHEST RADIOGRAPHY IN TUBERCULOSIS DETECTION-WHO/HTM/TB/2016. is available from

Kamaran Karadakhy, Nasih Othman, Faredun Ibrahimm, Akam Ali Saeed, Ari Abdul-Adheem Hama Amin Tuberculosis in Sulaimaniyah, Iraqi Kurdistan: A Detailed Analysis of Cases Registered in Treatment Centers. Tanaffos 2016; 15(4): 197-204.

MRA van Cleeff, LE Kivihya-Ndugga, H Meme, JA Odhiambo.PR Klatser.The role and performance of chest X-ray for the diagnosis of tuberculosis: A cost-effectiveness analysis in Nairobi, Kenya. BMC Infectious Diseases 2005, 5:111. DOI:

Chou-Han Lin, Chou-Jui Lin, Yao-Wen Kuo, Jann-Yuan Wang, Chia-Lin Hsu, Jong-Min Chen, Wern-Cherng Cheng, Li-Na Lee Tuberculosis Mortality: patient characteristics and causes, BMC Infectious Diseases 2014, 14:5, DOI:

H N Kisembo., S Den Boon, J L Davis, R Okelloo, W Worodoria, A Cattamanchi,L Huang , M G Kawooya. Chest radiographic findings of pulmonary tuberculosis in severely immunocompromised patients with the human immunodeficiency virus; The British Journal of Radiology, 85 (2012), e130–e139 DOI:

Edward E .Christensen Geral W. Dietz Chai HoAhn, John S. Chapman. Robert C.Murry. James Anderson. George A.Hurst.Initial Roentgenographic Manifestations of Pulmonary Mycobacterium Tuberculosis, M kansasii, and M Intracellularis Infections.; Chest.Volume 80, issue 2, August 1981, Pages 132-136. DOI:

Barry Rabinovitch. Madhukar Pai. Interpretation of Chest X-rays in Tuberculosis (GP Clinics-India; let’s Talk TB (supplement). 2nd edition, Mombai, India2016).

Aziza Ghanie Icksan, Martin Raja Sonang Napitupulu, Mohamad Arifin Nawas, Fariz Nurwidya Chest X-ray Findings Comparison between Multi-drug-resistant Tuberculosis and Drug-sensitive Tuberculosis. Journal of Natural Science, Biology and Medicine, J Nat Sc Biol Med 2018;9:42-46. DOI:

Khalid Omar Mohammad Ali. Correlation between chest X-ray & sputum investigation of pulmonary Tuberculosis in Salah Al-deen Governorate. Tikrit Medical Journal 2005; 11(2):47-49

N Ravi, BR Nagaraj, Bagath K Singh, Santosh KumarA study of various chest radiological manifestations of pulmonary tuberculosis in both human immunodeficiency virus-positive and human immunodeficiency virus-negative patients in south Indian population. West Africa journal of radiology. 2017, Volume: 24, Issue: 1, Page: 14-19. DOI:

Riccardo Piccazzo, Francesco Paparo, and Giacomo Garlaschi. Diagnostic Accuracy of Chest Radiography for the Diagnosis of Tuberculosis (TB) and Its Role in the Detection of Latent TB Infection: a Systematic Review. The Journal of Rheumatology Supplement 2014; 41 Suppl 91. DOI:

Yeon Joo Jeong. Kyung Soo Lee. Pulmonary Tuberculosis: Up-to-Date Imaging and Management. AJR: September 2008:191,834-844. DOI:

John H. Woodring. H.Mac Vandivier.Andrew M. Fried. Marcus L.Dilon. Irene G.Melvin. Update: The radiographic Features of Pulmonary Tuberculosis.AJR:146 March 1986. DOI:

Anna Rozenshtein.Frank Hao.Michael T. Starc.Gregory D. N. Pearson. Radiographic Appearance of Pulmonary Tuberculosis: Dogma Disproved. AJR 2015; 204:974–978. DOI:

Kumar A, Gautam K. A, Gupta K. A, Yadav P, Bhattacharya S, Kushwaha K.B. Radiological manifestations of HIV Pulmonary Tuberculosis co-infectionon. IJBAMR; 2015: Vol.-5, Issue- 1, P. 48-5248

Mathur, Manoj; Badhan, Rajesh K; Kumari, Sudesh; Kaur, Navkiran; Gupta, Saryu.Radiological Manifestations of Pulmonary Tuberculosis: A Comparative Study between Immunocompromised and Immunocompetent Patients. Journal of Clinical and Diagnostic Research JCDR. 11(9):TC06-TC09, 2017 Sep DOI:

Ashu Seith Bhalla, Ankur Goyal, Randeep Guleria, and Arun Kumar GuptaChest tuberculosis: Radiological review and imaging recommendations: Indian J Radiol Imaging. 2015 Jul-Sep; 25(3): 213–225. DOI:

Seyed Mohammad Alavi. Shokrollah Salmanzadeh. Pejman Bakhtiyariniya. Ali Albagi. Fatemeh Hemmatnia. Leila Alavi. Prevalence and treatment outcome of pulmonary and extrapulmonary pediatric tuberculosis in southwestern Iran. Caspian J Intern Med 2015; 6(4):213-219

Seyed Mohammad Alavi, Pejman Bakhtyarinia, Fatemeh Hematnia,Ali Albagi. Clinical and Radiographic Manifestations and Treatment Outcome of Pulmonary Tuberculosis in the Elderly in Khuzestan, Southwest Iran:Tanaffos. 2014; 13(4): 14–19.



How to Cite

Karadakhy K. RADIOLOGICAL MANIFESTATIONS OF PULMONARY TUBERCULOSIS IN PATIENTS REGISTERED AT DOTS CENTERS IN SULAIMANI, IRAQ 2010-2011. JSMC [Internet]. 2019 Dec. 21 [cited 2024 May 30];9(4):329-35. Available from:

Similar Articles

1-10 of 432

You may also start an advanced similarity search for this article.