Bone tuberculosis is an acute, progressive disease that is severely destructive. This type of disease is accompanied by active inflammatory processes. As a result of the disease, the deforming processes of the musculoskeletal system begin.
What is this ailment?
Tuberculosis of bones and joints has an infectious nature and is provoked by Koch's wand. The primary focus is formed at the time of penetration of the tubercle bacillus into the bones, into its spongy sections. Further, as it develops, the disease captures nearby cartilage and joints, leading to destructive processes in the bone tissue.
The disease most often affects the departments in which the bone marrow is the largest, such as the spine, hip, elbow, and knee joints. In the event that there is no timely, properly selected treatment, tuberculosis of the bones leads to very serious complications. Among them are shortening and even muscle atrophy, partial or complete immobility of the joints, the formation of a hump, deformation of the spinal column.
Tuberculosis of bones in adults has three phases of development:
- the occurrence of the primary focus;
- development and extinction of secondary arthritis;
- exacerbations and relapses.
Causes
The reasons for the development of turbulent bones can be various factors separately, as well as their combination.
The main causes of the development of this disease:
- Joint or bone injury. In this case, the likelihood of developing this disease will directly depend on the quality of restoration of the injured joint.
- A high load on the body, especially with improper nutrition or metabolic disturbance, can lead to incomplete recovery after an injury.
- Infectious disease can affect bone health.
- Decreased immunity.
- Unfavorable living conditions.
- Lack of vitamins and minerals.
- Stress.
Mostly the development of this disease begins after the so-called Koch sticks enter the body. From this moment, the symptoms and signs of bone tuberculosis begin to appear. If the human body is not weakened, then these bacteria can not harm him. If on the contrary, then begins the active division and reproduction of tuberculosis bacteria in the tissues. The rate of division depends on the method of treatment and the condition of the body as a whole.
Symptoms and signs
Bone tuberculosis is a life-threatening disease. Its nature consists in changing the structure of bone-cartilage tissue, skeletal muscle damage, profuse suppuration. It is immediately worth noting that the first signs of an abscessive process should be noticed by relatives and friends of the sick person and take this symptom seriously, since Koch’s wand and its derivatives are very contagious.
Symptoms and first signs of tuberculosis of bones and joints:
- a slight increase in body temperature;
- joint aches (arthralgia);
- weakness of the knee muscles, difficulty in flexion and extension of the arms;
- gait change;
- redness and swelling in the affected area;
- the appearance on the skin of pustules, pustules;
- fistula formation;
- destruction of bone and cartilage;
- a change in the shape of the articular bag (in later stages).
Carrying out diagnostic measures, the radiologist will immediately notice multiple spots in the image in the area of large tubular bones and joints. They will be an indirect confirmation of the diagnosis. It is possible to accurately determine the presence of tuberculosis only with the help of specialized blood tests that detect specific antibodies to Koch's bacillus. The symptoms of tuberculosis of bones and joints are not sufficiently informative.
Phases of the tuberculosis process
The first phase is called primary osteitis (focal). The second is progressive, it is divided into two stages:
- the development of uncomplicated osteitis,
- complete destruction of bone and articular segments.
The third phase is called metatuberculosis osteoarthritis.
First phase
Directly in the spongy internals of the bone structures, the formation of tuberculous granuloma begins. In the primary focus, it grows slowly, this phase can proceed without symptoms.
Second phase
Microorganisms begin to spread to the articular segments. Symptoms of bone tuberculosis begin to appear as follows. First, the synovial membranes will be affected. Joint cavities will accumulate pus, and the cartilage tissue of the joint will die and expose its entire surface. The second stage begins with necrosis of the articular bags, the formation of fistulas and the development of abscesses. The appearance of joint deformity is noted, their mobility decreases, the length of the arms and legs changes.
Third stage
All inflammatory processes disappear, while the joint completely and irrevocably loses its functionality. This stage ends with a complete and irreversible destruction of the articular system.
Diagnostic procedures
They diagnose bone tuberculosis with the help of clinical, radiological and laboratory examinations. First of all, the disease is diagnosed based on the characteristic clinical picture and patient complaints. Through X-ray examination, the disease is confirmed and the degree of damage is specified. Treatment is prescribed. Next, the attending physician monitors the progress of the disease.
During a visual examination, pay attention to the position of the affected part of the skeleton, the density of the articular bag, the color of the skin, swelling, muscle tone, the presence of pain. An affected limb is differentiated from a healthy one in order to determine what changes are present. The doctor also checks the mobility of the joint.
Laboratory methods for diagnosing the disease include: bacteriological, histological and cytological examination of the patient’s biomaterial, which is taken using a puncture or biopsy.
In the process of laboratory research, a study of the leukocyte formula, ROE and other blood characteristics is carried out.
In the process of bacterioscopic analysis, tuberculosis is not often detected. The main preference is given to cytological analysis, but this is not always informative. In the case of limited pathology, the site most likely will not fall into the contents of the puncture. An open biopsy is taken only when they doubt the diagnosis.
In order to verify the diagnosis, such types of studies as MRI, myelography, CT using a contrast agent are also used.
X-ray diagnostics
The main and earliest symptom of articular tuberculosis, which shows an X-ray examination, is bone osteoporosis. This process affects the entire bone, and not just the area where the pathology is actively developing. X-ray information shows each stage of the disease, but the development of symptoms is difficult to notice in the early stages, especially in mature patients due to decreased joint mobility and bone density for natural reasons.
The results of an X-ray examination perfectly reflect the following symptoms:
- Joint spaces are narrowed.
- Rough surface of cartilage.
- The presence of voids in the bones.
- Stratification of the intermuscular spaces, which appears as a result of edema.
In the presence of a tuberculous abscess, the image will have a shadow near the pathological site.
Drug treatment
Treatment of osteoarticular tuberculosis requires an integrated approach:
- medical;
- individual;
- traditional.
As part of a conservative therapeutic approach, bone tuberculosis is treated with medication.
Their list includes:
- Mitsin preparations (active substances - streptomycin, kanamycin, capreomycin, viomycin). They actively struggle with the inflammatory and parasitic process, help to cope with the deformation of cartilage, have a beneficial effect on already changed tissue structures.
- Ethambutol, Pyrazinamide are specialized drugs that work on Koch's bacillus. They are able to completely suppress the further spread of infection, stop the negative impact of the disease.
- Fluoroquinolones. This is a group of drugs that partially or completely repair damaged bone, cartilage, muscle tissue. The degree of their effect depends on the form of tuberculosis and the duration of the disease.
- Antihistamines. Since a decrease in immunity is due to an aggressive attack of foreign agents, maintenance therapy is prescribed. Sensitization-reducing drugs help the body more actively resist pathogenic bacteria and viruses.
- Angioprotectors (Actovegin, Trental, etc.). Restore the lost part of the bone-cartilage tissue of the joints. They help restore mobility lost due to bone tuberculosis.
- Antioxidants (Vitamin E, Sodium Thiosulfate). The elimination of toxins, metabolic products and bacteria is one of the most important stages of getting rid of the disease. Antioxidants capture harmful substances and naturally remove them from the body.
Surgery
Surgical treatment of bone tuberculosis varies depending on the particular development of the disease, but in any case, this type of treatment is the most traumatic. This type of treatment is usually prescribed at the last stage of the disease, when physiotherapy is no longer able to restore a large amount of destroyed bone and muscle tissue.
The following types of surgical intervention are distinguished:
- Removal of destroyed tissue in the area of periarticular and extraarticular foci.
- Complete removal of foci of infection.
- Removal of the synovial membrane of the joint.
- Removal of articular surfaces and cartilage.
- Removing a pathological lesion in a specific bone.
- Extraarticular resection within healthy tissues.
- Removing abscesses.
There are also a number of auxiliary operations aimed at restoring the functions of the joints:
- Operations aimed at restoring mobility in the joint.
- Operations aimed at restoring bone tissue.
- Implantation of artificial joints.
The choice of type of operation will depend on the phase and stage of development of the disease.
Alternative methods of treatment
The cause of tuberculosis is Koch's bacillus. It is highly resilient. To get rid of this ailment, some popular methods of treating bone tuberculosis have proven themselves well. However, it must be remembered that the decision on treatment in this way should be considered. It is necessary to weigh all the pros and cons, analyze the situation, consult your doctor, because bone tuberculosis is a disease that is very fast developing and can lead to serious complications with improperly selected treatment.
Do not forget that the treatment of such a serious illness with alternative methods is used together with the main, medical or surgical, treatment line.
An effective tool to combat the disease is a mixture prepared on the basis of garlic and horseradish. To do this, mix 50 g of horseradish pulp and the same amount of garlic with 0.5 kg of honey and half a pack of butter. Keep the product in the refrigerator. Take 50 g once a day 10-15 minutes before a meal.
There is another simple folk remedy: mix one raw chicken yolk with 1 teaspoon of lemon juice, beat with a fork until smooth. Take the mixture once a day after meals, preferably at night. Chicken yolk can be replaced with quail.
For another folk remedy, you will need 2 tbsp. l birch buds, insist them in 1 glass of alcohol and 1 liter of honey for 10 days. Be sure to consider that the composition should be infused in a dark place. Take strictly 2 teaspoons before meals three times a day.
Another recipe: mix 50 ml of aloe juice, 100 g of pork lard and 100 g of honey. Consume a mixture of 1 tbsp. spoon after eating. Store in a dark place. Additionally, you can take at night with a warm milk.
Dry the comfrey root in a mortar and mix in equal proportions with pork fat. Apply the finished ointment, evenly distributing in painful areas as a painkiller several times a day. For a good night's sleep, it is necessary to apply the composition in the evening, wrapping it with cling film on top.
In traditional medicine, much attention is paid to nutrition in the treatment of bone tuberculosis. The right choice of products is considered one of the success factors in the fight against the disease. A large amount of protein, both animal and vegetable, should be present in the patient’s diet. This is due to the fact that with tuberculosis, protein breaks down in the tissues. Along with protein, you should regularly eat carbohydrate-rich foods, preferably cereals. Vitamins obtained from fresh products, and, if necessary, from vitamin complexes, are needed.
Physiotherapy
If in case of tuberculosis of the bones the lesion area is small and during the procedures aimed at removing the inflammation, it was possible to defeat the active inflammation of bone tissues, then the doctor has the right to prescribe physiotherapy exercises to the patient. Physical therapy is mainly aimed at preventing the loss of muscle mass in the affected area, as well as stopping repeated bone deformities by strengthening the surrounding muscles.
The set of exercises is selected in such a way that the patient does not feel discomfort in the affected part of the body under such loads. At the same time, it is imperative to maintain the whole body in good shape, which will speed up metabolic processes.
The general tone of the body can be raised by regular massage or visiting the bath.
When conducting physical therapy, it is necessary to adjust the patient's diet. The diet requires the presence of dairy and other foods rich in calcium, as well as foods rich in protein and vitamins. You can take vitamin complexes.
If after physiotherapy exercises the patient felt a deterioration in well-being or joint mobility did not improve, then the patient may be prescribed arthroscopy or complete joint replacement.