Tuberculosis of Bones & Joints
What is it?
Tuberculosis of the bones and joints , is an extrapulmonary manifestation of tuberculosis. It is caused by an infection by Mycobacterium tuberculosis. When there is a tuberculosis infection, it can travel through the blood and reach the bones, spine and joints. Typically, because of the rich blood supply, it begins in the middle of long bones and vertebrae. It is a relatively rare condition, but often missed or diagnosed late because of chronic and non-specific symptoms and lack of awareness among clinicians. Risk factors include HIV infection or Aids.
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Signs & symptoms
Symptoms and signs of bone TB may include severe back pain, swelling, stiffness, and abscesses. When it is more advanced, it may include neurological complications, paraplegia or paralysis, limb shortening in children and bone deformities. Other systemic symptoms may include fatigue, fever, night sweats and weight loss.
Diagnosis
A confirmation of acid fast bacillus (AFB) from any body fluid or tissue is the gold standard for the diagnosis of tuberculosis. The Mantoux test is the recommended standard tuberculin skin test. Interferon gamma release assay (IGRAs) tests may be done to evaluate specific antigens. Bone imaging may also help to diagnose the disease. The gold standard for diagnosis of tubercular arthritis is synovial biopsy, with positive results in 80% of cases.
Treatment
Bone tuberculosis treatment is treated like pulmonary TB- with 4 drugs (rifampin, isoniazid, pyrazinamide, and ethambutol) for 6-18 months. Sometimes, a spinal surgery is necessary.
☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.
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