Analytical Study of Radiological Manifestations of Pulmonary Tuberculosis and Treatment Response Monitoring at Federal Teaching Hospital Bauchi, North East Nigeria

Pulmonary tuberculosis remains the most prevalent radiologically significant infectious disease in North East Nigeria, and the systematic characterisation of its radiological manifestations and the accuracy of imaging in monitoring treatment response fill an important clinical evidence gap in this high-burden region. This study analytically characterises the radiological manifestations of pulmonary tuberculosis and evaluates imaging-based treatment response monitoring at Federal Teaching Hospital Bauchi, North East Nigeria. A retrospective longitudinal design reviews chest radiograph and CT chest findings from 280 confirmed pulmonary TB cases managed between 2019 and 2023, including baseline, two-month, and six-month follow-up imaging where available. Radiological findings are classified and scored using the Ralph score for chest X-ray severity, with changes in score correlated against bacteriological sputum conversion data. Descriptive statistics, paired Wilcoxon signed-rank tests for radiological score changes, and Spearman correlation between radiological and bacteriological outcomes are computed in SPSS. Available TB radiology literature from North East Nigeria identifies upper lobe consolidation and cavitation as the most prevalent baseline presentations, with radiological improvement lagging bacteriological cure by two to three months. The WHO TB radiological assessment standards and the Modified Ralph Scoring System provide the analytical framework. Findings are expected to confirm the poor correlation between radiological and bacteriological response endpoints as a practical limitation of imaging-based monitoring. Recommendations address CT chest role clarification in treatment monitoring and standardised radiological reporting for TB follow-up at FTH Bauchi. Keywords: pulmonary tuberculosis, radiological manifestations, treatment response, Bauchi, North East Nigeria.