What is Bone Tuberculosis? How is it transmitted? Causes and Treatment

You can get sick with bone tuberculosis because of poor living conditions, physical overwork, getting injured, often recurring infectious diseases, hypothermia, poor working conditions.

Chief provocateur

Decisive in the development of such a disease as bone tuberculosis, is the previous contact with a person affected by this ailment. The disease is the result of the penetration of mycobacterium from the focus of tuberculosis in the lungs through the blood and lymphatic vessels in the bone. Therefore, bone structures that are well supplied with blood fall under attack. For example, the area of the shoulder, hip, spine, lower leg and forearm.

How does the disease develop?

With active multiplication of mycobacteria, the formation of specific tubercles occurs with granulomas, which subsequently break down. As a result, bone marrow tuberculosis develops. The bone substance undergoes dissolution, abscesses of the cavity, filled with purulent contents, fistulas, characterized by the absence of a connection between the bone and the external environment. Also, the severed parts of the dead bone (sequestration) are noted.

How is tuberculosis of the spine manifested?

Bone tuberculosis of the spine begins its development in one vertebra. When the granuloma grows, the bone tissue is dilated, the inflammation seizes neighboring parts of the spinal column. The spine is deformed. When the thoracic region is affected by squeezing the spinal cord, paralysis and paresis may form.

Symptoms of bone tuberculosis

Bone tuberculosis at the initial stage is characterized by a mild manifestation of symptoms. They may not manifest themselves at all. Patients complain of a slight increase in temperature to 37 degrees. Sometimes the temperature rises and is higher. Children become sluggish and drowsy, and adults feel asthenic nervousness and pulling pains in the muscles. Sharply decreases efficiency. Some people after physical exertion feel moderate pain in the spine area without a clear localization. After rest they pass.

Thus, it can be stated that the symptoms of the disease are worn out, so most people do not get timely medical help, because they explain their condition by simple overwork.

Important information

If the pain does not stop when taking analgesics or anti-inflammatory drugs, then they signal the presence of the development of such a disease as tuberculosis of the bone system, which it is impossible to cope with alone.

The spread of the pathological process beyond the vertebral divisions causes damage to the spinal column. This is the second stage of the disease.

What characterizes the second stage

Asthenia increases, body temperature rises to high marks. Together with this there is marked pain in one or another part of the spine. This pain limits the movement of a person. Violated his posture and gait. At rest, the intensity of pain decreases. Muscles along the spine are in tension, swell. When palpation, the patient is soreness.

The third stage of tuberculosis

Tuberculosis of bone tissue affects adjacent vertebrae. The general condition of the patient is characterized as severe. The ill person is much thinner, the body temperature keeps at around 39 or 40 degrees. The asthenic state is preserved . Pain in the spine is intense. At rest, they somewhat decrease.

After the treatment the spine of the patient remains deformed, dorsal muscle atrophy is observed , the mobility of a person is sharply limited. Some patients even after the cure continue to complain about instability in the spine and in the area of the affected vertebrae.

Tuberculosis of upper and lower extremities

This disease is inherent in the same stages as in spinal tuberculosis. What are the signs of bone tuberculosis of the extremities? The inflammatory process is characterized by pain, the skin turns red, puffiness is noted above the lesion. The destruction of the bone provokes deformity of the limb and the violation of the gait until the appearance of lameness. Work capacity drops sharply.

How the disease is diagnosed

All patients with suspected bone tuberculosis undergo a radiograph or tomography of the affected organ in two projections. In this case, it is necessary to determine the focus of bone destruction (sequestration) and shadows from abscesses.

In the presence of fistulas and abscesses, fistulography or abscessography is used to determine their extent. The cavity of the abscess or fistula is filled with contrast medium, then a number of pictures are taken.

When making a diagnosis, a crucial role is played by microbiological examination of areas of dead bone, the contents of an abscess or fistula.

What is evidence of bone tuberculosis

Bone tuberculosis confirms the presence of mycobacteria. A blood test indicates inflammation of an infectious nature. The number of leukocytes increased, accelerated ESR, appears C-reactive protein, etc. To confirm the disease, provocative and tuberculin tests are used.

Given that the disease can be secondary, it is necessary to undergo a chest x-ray, and in the presence of specific complaints to conduct an examination of other organs.

How is tuberculosis treated?

Bone tuberculosis, the treatment of which is different in duration, is eliminated by the rapid reduction of infection. Also, prevention of bone tissue destruction is achieved. There is a general restorative treatment.

Compliance with diet

In the active period of the inflammatory process, the patient experiences accelerated protein breakdown. Therefore, for its replenishment it is necessary to eat food that is rich in this substance. The amount of food consumed should increase by 1/3. The daily calorific value should be 3500 calories per day. In this case, excessive nutrition leads to an overload of the body and obesity, which in this disease is unacceptable.

In a day the patient should eat an average of 100-120 g of protein. At higher temperatures, protein intake should be reduced to 70 g per day.

Recommended food:

• Broth from meat or fish;
• Meat cutlets;
• pate;
• Boiled fish;
• Dishes with eggs.

The food ration should be supplemented with milk and lactic acid products. They contain calcium, which is necessary for the damaged bone.

In the inflammatory process, as well as during the course of treatment with antibiotics, consumption in large quantities of fruits and vegetables, as well as multivitamin complexes, is recommended.

Lifestyle with disease

With developed inflammation, a bed rest is recommended. During the treatment can be applied therapeutic exercise and massage. Ill person should often be outdoors. The beneficial effects of sunbathing. As a rule, patients undergo therapeutic and rehabilitation courses in specialized dispensaries and sanatoriums, where the regime of day and rest is strictly observed.

Treatment of the disease with medicines

The greatest effect is treated by antibiotics with a combination of surgical methods.

Drugs against bacteria are used both before and after surgery. Usually, doctors prescribe "Rifampicin", "Isoniazid", "Pyrazinamide", "Etambutol", etc. Medications are used for a long time. They are drinking according to a certain scheme.

Surgical intervention

The extent of surgical intervention depends on how much bone was broken, as well as the presence of abscesses and fistulas. The operative method can remove sequesters, cavities of abscesses and fistula strokes. They are washed with antiseptics and antibiotics. Such cavities with proper treatment are closed by themselves.

Much more difficult operations differ at a late stage of the disease with a rough deformation in the spine and bones. Such operations can not eliminate the disability of patients, but can alleviate the severity of the disease.

Rehabilitation course

Rehabilitation proceeds in stages. The main task is to restore the lost functions of the affected organ and return the patient to a full-fledged existence. At the same time, the use of therapeutic physical training, massage, physical therapy, as well as various techniques that promote social and professional rehabilitation is shown.

Complications

Tuberculosis of bone tissue can cause a number of complications:

• Curvature of the spinal column. On the site of lesions of the vertebrae, a hump often arises. This often entails a secondary deformation.
• When the spine is deformed, neurological disorders are noted in all patients, beginning with an increase in muscle tone or involuntary movements and ending with paresis and paralysis.
• Abscesses in the disease are located near the affected vertebrae. They can be distinguished by a long extension. The only way to treat is surgery.
• Fistulas occur at the exit of inflammation on the surface of the skin.

Prognosis of the disease

At present, there is practically no lethal outcome. But this disease is characterized by a very severe course with the appearance of deformations of an irreversible nature, which leads to a loss of ability to work. It is established that in about half the cases people become incompetent. Treatment is time-consuming, many drugs have toxicity.

Preventive measures

Common preventive measures are measures aimed at reducing the likelihood of contact with patients with tuberculosis, as well as preventing infectious, colds, injuries and poisoning.

Children and adolescents must undergo a planned trial for tuberculosis, as this helps in identifying the underlying disease. Referring to a doctor in case of pain in the bones and muscles helps to recognize the disease in the early stages and conduct timely effective treatment.

Tuberculosis of bones in children

An adult has a greater resistance to the disease with tuberculosis, since his immunity is more robust and developed. The child's body is more frail. Therefore, tuberculosis of the bones and spine often occurs in childhood.

The cause of infection in childhood

Under the influence of adverse conditions, the child's organism quickly becomes vulnerable to microbes.

Fertile soil for the development of tuberculosis is also acute infectious diseases. Among them, it should be noted influenza, measles and whooping cough. They contribute to the weakening of defensive forces.

Tuberculosis microbes in the body of a child who has recently undergone an infectious disease, easily provoke the development of damage to bones and joints. Therefore, parents should be attentive to the baby who has had severe infections, and at the slightest suspicion of tuberculosis, show it to the doctor. The specialist will appoint an appropriate examination.

How does a child's tuberculosis begin?

Most often, the bone tuberculosis of children develops secretly and slowly. Often the child complains of pain in the joints.

Some parents associate the onset of the disease with a fall or injury. But this judgment is fundamentally wrong. Without a painful focus in the bones, tuberculosis can not develop from a simple fall.

What complications can cause tuberculosis of the bones in a child

If a child does not provide medical assistance on time, tuberculosis can provoke an abscess in the joint and the appearance of long, non-healing fistulas. Disease of the joint can cause its destruction and impairment of mobility, shortening of the limb. Tuberculosis of the spine entails its curvature, hump formation and paralysis of the limbs.

With early detection of the disease and its correct treatment until the process is completely stopped, the disease proceeds in a lighter form and does not cause severe destruction in the joint.

It is very important not to miss the first stages of the disease, when the disease did not provoke degeneration of bone tissue. At this time, the patient can see clear signs of the disease. Signaling about the disease can both the joint itself, and the general condition of the child's body.

Symptoms

How does the child manifest bone cancer? Symptoms are varied. First of all, the child's mood must change. Once cheerful and cheerful, it changes, becomes lethargic and apathetic. Sharply loses weight, turns pale, suffers from a bad appetite, does not run, gets tired of walking, often rests, leaning his back against the wall. Among neurological signs, absentmindedness, rapid fatigue, restlessness can be noted.

Often, parents note that the child has become immobile and prefers rest activity. Sometimes the child has a temperature rise of 37.2 or 37.4 degrees. The patient has no specific complaints, but there is a sharp change in posture. With tuberculosis of the spine, there is stoop or excessive spontaneity of the spine. The shoulders are raised, and the neck or head is crooked.

Sitting, the child rests his hands on the chair, and if desired, bend the back produces an emphasis on the hands of the knees. When the joint is affected, he begins to drag his foot. The clubfoot is often observed. The child tries not to tread on the affected leg.

Much less often osteoarticular tuberculosis debuts with light lameness. Parents think that a child indulges, and scolds him. For a while his gait and posture are leveled, but then everything returns. If the hand is hit, the child instinctively protects it, making movement only with a healthy hand. There are no complaints of pain. These phenomena are caused by a reduction in the normal mobility of the joint due to muscle tension.

If the parents put the child to bed, he again starts moving the affected arm or leg, his correct posture will be restored. However, after a while, there will be again a restriction of mobility, gait and posture will change. These disorders appear as periods and become one of the first and characteristic symptoms of bone tuberculosis. Painful sensations, as a rule, are not observed at the first stages.

The bony form of tuberculosis at the initial stage of development causes slimming of the affected arm or leg. Soft tissues become flabby. Complaints of pain appear much later.

Often the pain is localized at a sufficiently large distance from the place of development of the process. For example, with tuberculosis of the spine, the child observes pain in the abdomen, back, ribs and arms. When tuberculosis of the hip is concerned, the knees.

When the spine is damaged, wheezing can occur during breathing. Sometimes a child screams at night from pain with careless movements during sleep.

It is very important to catch the very first symptoms and consult a doctor in time.

Conclusion

Bone-joint tuberculosis is an insidious disease. It can be triggered by infections, as well as transmitted from the infected person. The disease is distinguished by the duration of the course. For example, it takes about 2-3 years to heal the spine or large joints in childhood.

The earlier the presence of the disease was established and the appropriate treatment was started, the better the outcome of the disease.