You can get bone tuberculosis due to poor living conditions, physical fatigue, injury, often recurring infections of an infectious nature, hypothermia, poor working conditions.
The main provocateur
Decisive in the development of a disease such as bone tuberculosis is previous contact with a person affected by this disease. The disease is the result of penetration of mycobacteria from the focus of tuberculosis into the lungs through the blood and lymph vessels in the bone. Therefore, bone structures that are well supplied with blood fall under attack. For example, the area of the shoulder, thigh, spine, lower leg and forearm.
How does the disease develop?
With the active reproduction of mycobacteria, the formation of specific tubercles of granulomas occurs, which subsequently collapse. As a result, bone marrow tuberculosis develops. Bone substance undergoes dissolution, abscesses of the cavity are filled with purulent contents, fistulas characterized by the absence of a connection between the bone and the external environment. Also torn off sections of dead bone (sequestra).
How is tuberculosis of the spine
Bone tuberculosis of the spine begins its development in one vertebra. With the growth of granulomas, a rarefaction of bone tissue occurs, inflammation captures neighboring areas of the spinal column. The spine undergoes deformation. When the thoracic region is affected by compression of the spinal cord, paralysis and paresis can form.
Symptoms of bone tuberculosis
Bone tuberculosis at the initial stage is characterized by a mild manifestation of symptoms. They may not show themselves at all. Patients complain of a slight increase in temperature to 37 degrees. Sometimes the temperature rises and higher. Children become lethargic and drowsy, while adults feel asthenic nervousness and pulling pains in the muscles. Dramatically reduced performance. After exercise, some people experience moderate pain in the spine without a clear localization. After the rest, they pass.
Thus, it can be stated that the symptoms of the disease are erased, so most people do not receive timely medical care, as 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 a disease such as tuberculosis of the skeletal system, which cannot be managed on its own.
The spread of the pathological process beyond the redistribution of the vertebra causes damage to the spinal column. This is the second stage of the disease.
What is characterized by the second stage
Asthenia increases, body temperature rises to high levels. Along with this, severe pain is noted in one or another section of the spine. This pain restricts a person’s movement. Violated his posture and gait. At rest, the intensity of the pain decreases. The muscles along the spinal column are in tension, swell. On palpation, the patient has pain.
Third stage of tuberculosis
Bone tuberculosis affects neighboring vertebrae. The general condition of the patient is characterized as severe. The sick person is significantly losing weight, body temperature is at around 39 or 40 degrees. An asthenic condition persists . Pain in the spine is intense. At rest, they decrease slightly.
After the treatment, the patient's spine remains deformed, atrophy of the spinal muscles is observed , the mobility of the person is sharply limited. Some patients even after treatment continue to complain of instability in the spine and in the area of the affected vertebrae.
Tuberculosis of the upper and lower extremities
This disease has the same stages as with spinal tuberculosis. What are the signs of bone tuberculosis of the extremities? The inflammatory process is characterized by pain, the skin turns red, swelling is noted over the affected area. Destruction of the bone provokes deformation of the limb and impaired gait until the appearance of lameness. Disability drops sharply.
How is the disease diagnosed?
All patients with suspected bone tuberculosis undergo x-ray or tomography of the affected organ in two projections. In this case, the focus of bone destruction (sequestra) and the shadow of abscesses should be determined.
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 series of pictures is taken.
When making a diagnosis, the most important role is played by the microbiological examination of the areas of dead bone, the contents of the abscess or fistula.
Which indicates bone tuberculosis
Bone tuberculosis confirms the presence of mycobacteria. A blood test indicates an infectious inflammation. The number of leukocytes is increased, ESR is accelerated, C-reactive protein appears, etc. Provocative and tuberculin tests are used to confirm the disease.
Given that the disease can be secondary, it is necessary to undergo a chest x-ray, and if there are complaints of a specific nature, examine other organs.
How is bone tuberculosis treated?
Bone tuberculosis, the treatment of which is of a long duration, is eliminated by the quickest relief of infection. Prevention of bone destruction is also achieved. General strengthening treatment is carried out.
Dieting
In the active period of the inflammatory process, the patient has an accelerated protein breakdown. Therefore, to replenish it, it is necessary to eat food that is rich in this substance. The amount of food consumed should increase by 1/3. Daily calories should be 3,500 calories per day. In this case, excessive nutrition leads to overload of the body and obesity, which is unacceptable with this disease.
A patient should eat an average of 100-120 g of protein per day. At elevated temperatures, protein intake should be reduced to 70 g per day.
Recommended Food:
- meat or fish broth;
- meat cutlets;
- pate;
- boiled fish;
- dishes containing eggs.
The diet should be supplemented with milk and lactic acid products. They contain calcium, which is necessary for damaged bones.
In the inflammatory process, as well as during the course of antibiotic treatment, the consumption of a large number of fruits and vegetables, as well as multivitamin complexes, is recommended.
Disease lifestyle
With developed inflammation, bed rest is recommended. In the course of treatment physical therapy and massage can be applied. A sick person should often stay outdoors. Sun baths have a beneficial effect. As a rule, patients undergo treatment and rehabilitation courses in specialized dispensaries and sanatoriums, where the regimen of the day and rest is strictly observed.
Drug treatment
The treatment with antibiotics with a combination of surgical methods has the greatest effect.
Preparations against bacteria are used both before and after surgery. Usually, doctors prescribe Rifampicin, Isoniazid, Pyrazinamide, Ethambutol and others. Medications are used for a long time. They are drunk in accordance with a specific pattern.
Surgical intervention
The amount of surgery depends on how much the bone was destroyed, as well as the presence of abscesses and fistulas. The operational method can remove sequestration, abscess cavities and fistula moves. They are washed with antiseptic agents and antibiotics. Such cavities, with proper treatment, close themselves.
The operations are much more complex in the late stage of the development of the disease with severe deformation in the spine and bones. Such operations cannot 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 existence. At the same time, the use of physiotherapy exercises, massage, physiotherapy, as well as various techniques promoting social and professional rehabilitation is shown.
Complications
Bone tuberculosis can cause a number of complications:
- Spinal curvature. A hump often occurs at the site of vertebral lesions. This often entails secondary deformation.
- With spinal deformity, all patients have certain neurological disorders, ranging from increased muscle tone or involuntary movements to paresis and paralysis.
- Abscesses in the disease are located near the affected vertebrae. They can be distinguished by a large extent. The only treatment is surgery.
- Fistulas occur at the exit of inflammation on the surface of the skin.
Disease prognosis
Currently, almost no deaths occur. But this disease is characterized by a very severe course with the appearance of deformations of an irreversible nature, which leads to disability. It is established that in about half of cases people become incapacitated. The treatment is long, many drugs are toxic.
Preventative measures
General preventive measures are measures aimed at reducing the likelihood of contact with patients with tuberculosis, as well as the prevention of infectious, colds, injuries and poisoning.
Children and adolescents should undergo a routine tuberculosis test, as this helps in identifying a latent disease. Consulting 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 greater resistance to tuberculosis, since his immunity is stronger and more developed. The children's body is more weak. Therefore, tuberculosis of the bones and spine is often found in childhood.
The cause of infection in childhood
Under the influence of adverse conditions, the children's body quickly becomes vulnerable to germs.
Acute infectious diseases are also fertile ground for the development of tuberculosis. Among them, influenza, measles and whooping cough should be noted. They contribute to the weakening of defenses.
Tuberculosis microbes in the body of a child who has recently had 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 prescribe an appropriate examination.
How does tuberculosis of bones in a child begin?
Most often, bone tuberculosis in children develops stealthily and slowly. Often a child complains of pain in the joints.
Some parents attribute the onset of the disease to a fall or bruise. But this judgment is fundamentally wrong. Without a painful focus in the bones, tuberculosis from a simple fall cannot develop.
What complications can bone tuberculosis in a child cause?
If the child does not receive medical attention on time, then tuberculosis can provoke an abscess in the joint and the appearance of long unhealed fistulas. Disease of the joint can cause its destruction and impaired mobility, shortening of the limb. Tuberculosis of the spine entails its curvature, the formation of a hump and paralysis of the limbs.
With the early detection of the disease and its proper treatment until the process is completely stopped, the disease proceeds in a milder 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. The joint itself, as well as the general condition of the child's body, can signal an illness.
Symptoms
How does bone tuberculosis manifest in a child? Symptoms are varied. First of all, it should alert the change in the mood of the child. Once cheerful and cheerful, he transforms, becomes lethargic and apathetic. He suddenly loses weight, turns pale, suffers from poor appetite, does not run, gets tired of walking, often rests, leaning his back against the wall. Among the neurological signs, distraction, rapid fatigability, and restlessness can be noted.
Parents often note that the child has become motionless and prefers peace to activity. Sometimes the child rises in temperature to 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, stoop or excessive directness of the spine is noted. In this case, the shoulders are raised up, and the neck or head is kept crooked.
Sitting down, the child rests his hands on a chair, and if you want to bend your back, he puts his hands on his knees. When the joint is affected, it begins to drag the leg. Often clubfoot is observed. The child tries not to step on the affected leg.
Much less commonly, osteoarticular tuberculosis makes its debut with mild lameness. Parents think that the child indulges, and scold him. For a while, his gait and posture levels out, but then everything returns. If a hand is affected, then the child instinctively protects it, producing movement only with a healthy hand. There are no complaints of pain. These phenomena are caused by a reduction in normal joint mobility due to muscle tension.
If the parents put the child to bed, he will again begin to move the affected arm or leg, his correct posture will be restored. However, after some time mobility will again be observed, gait and posture will change. These disorders appear in periods and become one of the first and characteristic symptoms of bone tuberculosis. Pain, as a rule, is not observed in the first stages.
The bone form of tuberculosis at the initial stage of development causes weight loss 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 notes pain in the abdomen, back, ribs and arms. With tuberculosis of the hip, the knees bother.
If the spine is affected, grunting during breathing may occur. Sometimes a child screams at night in pain from careless movements during sleep.
It is very important to catch the very first symptoms and consult a doctor in time.
Conclusion
Osteoarticular tuberculosis is an insidious disease. It can be triggered by infections, as well as transmitted from an infected person. The disease is characterized by a duration of the course. For example, it takes about 2-3 years to cure the spine or large joints in childhood.
The sooner the presence of the disease has been established and the appropriate treatment started, the better the outcome of the disease.