Bone Tuberculosis: Symptoms and Treatment
Bone tuberculosis is an ailment that develops as a result of the active activity of tubercle bacilli, which in medicine are also known as Kocha sticks. As a result of their penetration into the joint, fistulas are formed, which do not heal for a long time, its mobility is disrupted, and in more severe cases it completely collapses. With the development and progression of tuberculosis of the spine, a hump can develop and a spin may bend. Without proper treatment, limb paralysis occurs.
Factors contributing to the development of pathology:
- drinking large quantities of alcoholic beverages
- persistent physical overload
- frequent injuries of the musculoskeletal system
- Adverse conditions of life.
Bone tuberculosis can develop both initially and during the generalization of the infectious process in secondary tuberculosis. MTB is transmitted from a sick organism to a healthy airborne droplet. Further, mycobacteria with blood flow are transferred to bone structures. Around them gradually begin to form. Granulomas, which as the disease progresses, can merge and form one large conglomerate. In its center there will be a zone of curdled necrosis. The larger the volume of affected tissues, the brighter will be the symptoms of tuberculosis of bones and joints.
Many believe that if the mycobacterium tuberculosis has already penetrated the human body, then it will definitely fall ill with tuberculosis. In fact, this is not so. If a person has a healthy immune system, Koch’s sticks can not do any harm to him, since the body itself prevents the progression of pathology. Often, tuberculosis of the spine or other bones and joints can be eliminated on their own, without exerting any influence on the human body. But if the immune system is weakened or if a person has recently undergone a serious illness, the rods can provoke the progression of tuberculosis in any organ, spine or joints.
Phases of the disease
Bone tuberculosis occurs in 3 phases:
- preartritic phase, also called primary ostitis
- arthritic phase or secondary arthritis
- Postartritic phase.
Bone tuberculosis is of several kinds:
- Tuberculosis drives. This type of pathology accounts for up to 20% of all cases of tuberculosis of bones and joints
- Tuberculosis of the spine;
- Tuberculosis coke This type of disease affects mainly children. Danger that without timely treatment can lead to deformation and dislocation of this joint;
- Tuberculosis of the ankles and feet. The disease proceeds with the formation of long non-healing caverns. If you do not diagnose it in time and do not perform a specific treatment, it can progress and lead to immobility of the joint. This is due to the fact that the articular surfaces coalesce;
- Tuberculosis of the wrist joints. This type is rare. Its characteristic feature is bilateral defeat (two joints are affected immediately). The disease rarely occurs independently, most often it is combined with pathologies of other joints;
- Olenitis. This form of the disease mostly affects young people
- Tuberculosis of tubular bones. This form is extremely rare.
Tuberculosis of the joints and bones affects mostly young children. The disease at an early stage of development is very difficult to recognize, because at this time it does not have any severe symptoms. Many people are sure that the symptoms of tuberculosis of bones begin to appear in an adult or child after a fall or a strong blow. In fact, this statement is not true. The impact, even very strong, can not provoke the progression of tuberculosis.
If you carefully observe a child or an adult, then there is an opportunity to identify the ailment at an early stage of its development. It is very important to pay attention to the patient’s behavior. If this is a child, then he will refuse to play mobile games, will be irritable, listless. These are the first signs that the baby’s body is not all right. In addition, the child can begin to limp, stoop, lift up his shoulders or to clum.
In an adult, the early stage of development of pathology is very poorly expressed. Usually it is manifested by symptoms that a person regards as normal overwork:
- feeling of heaviness in the spine
- fast fatigue;
- Back pain.
Symptoms of tuberculosis of the bones become most pronounced in the 2 nd phase of the progression of the disease. Pain in joints and spine is worse. By nature, they are similar to pain in intercostal neuralgia or radiculitis. There is a restriction of mobility, the muscles of the back become rigid and lose their elasticity.
In the area of the affected joint or spine, there is swelling, tissue atrophy, and accumulation of exudate. Limbs are shortened, muscles are thinned and abscesses are formed.
Tuberculosis of bones and joints is very difficult to diagnose, especially in the early stages of its development. Diagnosis involves a combination of the following studies:
The plan for conducting diagnostics in medical institutions is as follows:
- conducting general clinical studies
- Radiologic examination, which makes it possible to confirm the diagnosis
- tuberculin diagnostics
- microbiological examination of material taken from a biopsy
Treatment of tuberculosis of the spine and other joints and bones is a very complex process.
Its main directions:
- complete destruction of the infectious agent
- prevention of bone tissue destruction
- strengthening the patient’s immune system
- general restorative treatment
To treat this ailment, doctors prescribe anti-tuberculosis chemotherapy. Selection of the scheme is carried out only by highly qualified specialists and in stationary conditions. Synthetic first-line drugs (Pyrazinamide, Isoniazid) and second-line drugs are used.
In order to properly draw up a treatment regimen and choose the most effective drugs, the doctor necessarily takes into account the development phase of the pathological process, the age of the patient, the presence of accompanying pathologies, the weight of the patient, etc.
Surgical treatment is indicated if the medication did not give the desired result, and the disease continues to progress.
The direction of such treatment is as follows:
- complete removal of the bone site destroyed by tuberculosis
- creating the most favorable conditions for treatment
- Correction of consequences of the transferred illness.
Also in the treatment plan for tuberculosis of the spine and other bones and joints is:
- orthopedic treatment
- exercise therapy
- sanatorium treatment