Imaging in discriminating intestinal tuberculosis and Crohn’s disease: past, present and the future

Pradeep Goyal, Jimil Shah, Sonali Gupta, Pankaj Gupta, Vishal Sharma

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


Introduction: Intestinal tuberculosis (ITB) and Crohn’s disease (CD) have similar clinical presentation, but require different treatment approaches. Despite advances in various endoscopic, imaging, microbiological, and histological techniques, the differentiation of these two entities is often difficult. Newer radiological and image acquisition modalities have now become indispensable tools for evaluation of these two diseases. Areas covered: This review summarizes the currently available literature on various radiological investigations to differentiate ITB from CD. This review also enumerates the newer modalities in image acquisition techniques and their potential role for differentiating these two diseases. At present abdominal computed tomography (CT) scan is used as a first line investigation for differentiating ITB from CD. Magnetic resonance imaging (MRI) is preferred in pediatric patients and for follow-up studies. Expert opinion: Role of newer modalities like contrast enhanced abdominal ultrasound, perfusion CT, advanced MRI and positron emission tomography (PET) is evolving and requires further exploration. Till further robust studies are available, differentiation between ITB and CD requires use of a combination of clinical, endoscopic, serological, histological, and radiological parameters rather than relying on a single test.

Original languageEnglish (US)
Pages (from-to)995-1007
Number of pages13
JournalExpert Review of Gastroenterology and Hepatology
Issue number10
StatePublished - Oct 3 2019
Externally publishedYes


  • Computed tomography
  • colonoscopy
  • gastrointestinal
  • response to therapy
  • serology
  • stricture
  • tuberculosis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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