Bone TB comprises a group of severe infectious diseases whose suffering has increased in the last two decades, especially in the underdeveloped countries of the world. As a result of this, stiffness and abscesses develop in the affected joints. Bone TB severely affects the joints of the hips and knees. It is also a bonus disease for AIDS patients. A typical tuberculous like osteoarticular manifestations are common. It causes pain in the extraspinal skeleton, trochanteric area, or a prosthetic joint. The infections proceed in favourable epidemiological contexts. Surgery, in combination with prolonged antituberculosis chemotherapy, is mainly indicated in patients with bone manifestations or deformities.
Bone TB generally arise from reactivation of bacilli lodged in the bone. At the time of mycobacteria’s primary infection, the effect of bacillus for the spine and large joints is due to the plentiful vascular supply of the vertebra or growth plates of the long bones. Tuberculous arthritis or bone TB results from one extension of an initial infection and go from bone to the joint.
Types of Bone TB:
There are various categories of bone TB, and different method of treatment is available for different types of bone TB. Some of the classes are as follows:-
- Tuberculosis of spine
- Tuberculosis of hip joint
- Tuberculosis of elbow
- Tuberculosis of knee joint
- Tuberculosis of ankle joint
- Tuberculosis of upper extremity
Causes of Bone TB:
Bone TB occurs when you get in contact with a patient suffering from tuberculosis by the transmission of M. tuberculosis bacteria. Bone tuberculosis has fewer cases in the last few decades because the prevalence of the treatment has increased a lot. A primary cause to be infected from bone TB are follows:-
- Tuberculosis – It is a causative agent for TB. When it gets inside the human body, it can cause damage to lymph nodes, thymus, including bones.
- Transmission – Tuberculosis is an infectious disease; thus, it spreads quickly from person to person through the air.
- Improper treatment – If any person suffering from Lungs TB or any TB is not taken care of from the beginning, then the bacteria will move to the abundant vascular supply of the long bones and cause bone TB.
Sign and Symptoms of Bone TB:
The most common symptoms a person face while suffering from Bone TB are follows:-
- Pain at joints.
- Pott disease. ( spinal TB )
- Back pain.
- Carpal tunnel syndrome.
- Cushioning of the vertebral disc.
- Uneasiness in the thoracic region.
- Pain in the carpal bone. ( Carpal tunnel syndrome)
- Wrist pain. ( in case of vertebral bone defects )
- Spinal hump.
- Destruction of vertebrae, discs.
- Feeling the dislodging of the bones.
- No cough and fever.
- Osteoarticular manifestations.
- Neurological disorders.
- Soft tissue swelling.
- Deformities in bone structures.
Treatment and Prevention from Bone TB:
Bone TB can lead to some painful side effects, but the damage is reversible when it is treated early stage with the right regimen of medications.
- Surgery – At the coarse situation, spinal surgery is necessary — the treatment of laminectomy, where a part of the vertebrae, is removed for treatment.
- Medications – Taking medicines are the first line of treatment for bone TB, and the duration of treatment can last from 6–18 months. The most common medications used for the cure are rifampicin, ethambutol, isoniazid, and pyrazinamide.
- Prevention measure – Tobacco, Excessive consumption of alcohol, Refined products, Greasy food like chicken, chips, onion, and other fried items or foods that have high saturated fat.
- MDR-Therapy – This therapy includes the combination of antitubercular drug which have different pharmacological action. MDR is the most suitable method of treatment for bone TB.
- DOTS therapy – DOTS or “directly observed treatment short course” is a method that recommends bone TB therapy, which involves the list of all the drugs coming under the classification of antitubercular medication.
- XDR-TB – It is also known as Extensively Drug-Resistant Tuberculosis. It includes all the rug Resistant to the causative agent M. Tuberculosis. It consists of all the second-line drugs. It contains drugs like aminoglycosides, polypeptides, thiazides, and Para aminosalicylic acid for the procedure.
Dr. Indranil Biswas, Consultant – Orthopaedics | Narayana Multispeciality Hospital, Barasat