Bone Tuberculosis: Symptoms and Treatment

Tuberculosis of bones

Tuberculosis of bones- the second most common form of tuberculosis after pulmonary tuberculosis. Possible damage to the spine and bones of the limbs. Can be diagnosed at any age.

The disease occurs under the influence of a number of factors, including - hypothermia, adverse social conditions, severe physical labor, reduced immunity, etc.

, but contact with the tuberculosis patient plays a decisive role. The diagnosis is made on the basis of radiography, tomography and other studies.

At the initial stages, the treatment is conservative, with considerable destruction of the bones, operations are performed.

Tuberculosis of bones is an infectious disease caused by tuberculous mycobacteria (Koch chopsticks). Affects areas of spongy substance with abundant blood supply, accompanied by the formation of foci of destruction, abscesses and fistulas.

Often becomes the cause of deformation of the affected segment, can cause contractures and limb shortening.

At a tuberculosis of a backbone probably the expressed curvature of a backbone, formation of a hump, and in severe cases - and a paralysis of extremities.

The combination with active pulmonary tuberculosis is quite rare (about 3% of cases), however, when Radiography of the lungs in patients revealed characteristic areas of calcification in the area of ​​lymph nodes or upper lobes of the lungs (often right). Treatment of this pathology is carried out by phthisiatricians.

Causes of development of tuberculosis of bones

Tuberculosis of bones, like other forms of tuberculosis, develops when Koch's rods enter the body. At the same time, infection with mycobacteria does not always lead to the development of the disease.

The disease occurs when the patient's body is weakened by hypothermia, too heavy physical labor, other infectious diseases and unfavorable living conditions, and mycobacteria tuberculosis are in a state of readiness for active fission or a reproductive state (as with active tuberculosis).

The first focus arises in the lungs, then the mycobacterium spreads through the lymphatic and blood vessels and into the bone.

The greatest risk is exposed to parts of the bone with good blood supply (vertebrae, epiphyseal sections of the femur, bones of the lower leg, humerus and forearm bones). As a result of the reproduction of Koch's rods, small tubercles-granulomas appear in the bone.

When the granulomas increase, the bone substance is destroyed, abscesses are formed, which can later be opened outward, forming fistulas.

In most cases, mycobacteria "settle" in the immediate vicinity of the joint, so when the infection spreads into the process, intraarticular structures are involved. There are three phases of development of tuberculosis of bones.

The severity of residual events depends on the time of the beginning of treatment, the adequacy of therapy and the state of the patient's body.

Because the tuberculosis process in most cases captures not only the bone, but also the joint, scientists and practitioners usually use the term "osteoarticular tuberculosis". There are following forms of this disease:

• Tuberculosis of the spine.May suffer as one vertebra, and several. In 60% of cases, there is a lesion of the thoracic region, in 30% - of the lumbar region.
• Tuberculosis of the knee joint(drives). The most common tuberculous lesion of the joints is more often detected in adolescence.
• Tuberculosis of the hip joint(coxite). It often develops in children, it can cause a significant shortening of the limb and the formation of a pathological dislocation of the hip joint.
• Tuberculosis of the ankle and foot bones.It is accompanied by the formation of long-existing fistulas and caverns. Often leads to ankylosis of the joint due to the fusion of the joint surfaces.
• Tuberculosis of the shoulder joint(omartrite). It is rarely found. The course of a prolonged, purulent effusion in the joint is usually absent.
• Tuberculosis of the wrist joint.Another rare form of the disease. There is a lesion of the joint and bones of the wrist, usually bilateral. It is often combined with tuberculosis of the elbow or knee joint.
• Tuberculosis of elbow joint(a reindeer). Usually develops in adolescence. At a delayed start of treatment, fecal fistulas and abscesses are formed.
• Tuberculosis of tubular bone without joint damage.It is very rare, usually found in children, characterized by the defeat of metacarpal bones and the main phalanges of the hand.

Symptoms of Bone Tuberculosis

Tuberculosis of bones begins gradually, gradually. Specific symptoms in the early stages are absent.

Patients are concerned about weakness, irritability, lethargy, decreased performance, aching or pulling pain in the muscles and a slight increase in temperature.

In some patients, after physical exertion, there are non-intensive pains in the affected part of the skeleton, rapidly disappearing at rest. Children with tuberculosis of bones become distracted, refuse to play games.

The cause for alertness for parents should be raised shoulders, clubfoot, sudden stoop or limping without previous injury. Sometimes it is noticeable that the child keeps his foot, tries to step less on it, does not jump on it, or hides after a long walk.

In the second phase of bone tuberculosis, the process extends beyond the bone or vertebra, the symptoms become more vivid. The body temperature increases even more, weakness, lethargy and weakness intensify. There are intense pain in the affected area.

When the focus is localized in the vertebrae, a disorder of posture is formed, the near-vertebral muscles become inflamed, swollen and become painful on palpation.

When the limb is damaged, the joint becomes red and swollen, progressive deformation occurs, gait disturbances and lameness are noted.

With further progression of bone tuberculosis, the patient's condition is further aggravated. There is a pronounced general weakness, an increase in body temperature to 39-40 degrees and weight loss. The intensity of pain increases, the pain syndrome becomes intolerable.

Deformations intensify, movements are further restricted.

The outcome, depending on the severity and prevalence of the process, can be a limitation of mobility, atrophy of the back muscles, deformation of the spine, deformity and shortening of the limb, contracture or ankylosis the joint.

To confirm the diagnosis, x-rays of the chest, x-ray of the affected segment and MRI of the affected segment are prescribed.

On the roentgenograms of the spine or the injured bones of the limbs, foci of destruction and sequestration are visible. In some cases, it is possible to notice the shadows of the abscesses.

Perform tuberculin tests, sometimes conduct a microbiological study of the contents of the fistula or abscess to identify Koch sticks. With fistulas or abscesses, an abscess or fistulography is performed.

In the course of the study, the cavity is filled with contrast medium, and then a series of images is taken, allowing to estimate the size and configuration of abscesses and fistulous passages.

This technique is of great practical importance in the preparation of the plan for surgical intervention.

Treatment of tuberculosis of bones

Treatment of tuberculosis of bones is complex, includes diet, restorative measures and drug therapy.

Patients are sent to specialized centers, dispensaries and sanatoriums.

In the active phase, the bed rest is prescribed, in the subsequent it is recommended to be more outdoors and take sun baths, apply massage and exercise therapy.

In the active phase in the patient's body, the protein decomposes strongly, so that it increases the amount of food by 1/3 as compared to the norm and prescribe an easily digestible diet with a high protein content, including eggs, boiled fish, ground meat dishes, fish and meat soups broth. During the recovery period, the amount of dairy products is increased, during the period of antibiotic therapy it is recommended to consume a large number of fresh fruits and vegetables.

The size of the operation depends on the absence or presence of fistulas and abscesses, as well as on the degree of bone destruction. The sequesters are excised, the fistulous passages and cavities of the abscesses are washed with solutions of antibiotics and antiseptics.

With a favorable flow of the cavity over time, close, with an unfavorable - excised by a surgeon.

In the event of gross defects and serious anatomical disorders in the late period, corrective and reconstructive operations are performed.

At the final stage, rehabilitation measures are implemented to restore the function of the affected segment and return the patient to normal life.

In the process of rehabilitation of patients with bones tuberculosis, physiotherapy, massage and exercise therapy are used, and social and professional rehabilitation is carried out.

Prognosis and prevention of tuberculosis of bones

The prognosis for life in tuberculosis of bones is favorable. The use of combined methods of treatment and modern antibacterial drugs has made it possible to reduce the lethality to almost zero.

However, in the long-term period, deformations of the affected segment of one degree or another are observed in many patients. Half of patients with spinal tuberculosis get disability.

Patients with foci in limb bones often have lameness, shortening and deformity of the limb, as well as contractures of varying severity.

Prevention of the disease consists in minimizing contacts with patients with active tuberculosis, preventing intoxication, trauma and hypothermia.

An important role is played by improving the overall standard of living and ensuring social well-being. Parents are advised not to refuse to conduct planned tuberculin samples to children.

Serious nonspecific symptoms (weakness, weakness, slight increase in temperature) should be taken seriously if they persist for several weeks.

A source: http://www.krasotaimedicina.ru/diseases/traumatology/bone-tuberculosis

Tuberculosis of bones

Bone tuberculosis is the most common form of tuberculosis after pulmonary tuberculosis.

The disease can occur at any age, but more often affects adults.

Tuberculosis occurs in various departments of the musculoskeletal system, but, as a rule, most often the pathological process develops in the spine.

Causes of Bone Tuberculosis

The development of the disease contributes to increased physical stress, trauma, recurring diseases, including infectious, hypothermia, unfavorable living and working conditions.

Crucial is the previous contact with the patient with tuberculosis.

The disease occurs when infecting the infection - mycobacterium tuberculosis from the tuberculosis focus in the lungs through the blood and lymph vessels in the bone.

Therefore, in the risk zone are the bone structures that have a good blood supply, such as the humerus, femur, vertebral bodies, the shins of the lower leg and the forearm.

During the reproduction of mycobacteria, specific tubercles-granulomas are formed, which then undergo destruction.

When the granuloma grows, the bone substance dissolves, abscesses are formed (a cavity filled with pus), fistulas (absent Normally, the connection between the bone and the external environment, having inflammatory origin), sequestration (the detached part of the necrotic bones).

With tuberculosis of the spine, the disease begins, as a rule, in one vertebra.

When the thoracic spine is affected, often due to compression of the spinal cord, paresis and paralysis are formed.

Possible symptoms of bone tuberculosis

ATbeginning of the diseaseThe characteristic manifestations of tuberculosis can be expressed little or none at all. Patients are concerned about a moderate increase in temperature to 37 ° C, rarely higher.

Children become sluggish, drowsy, adults complain of a pronounced general weakness, irritability, pulling, aching muscles, reduced performance.

In some patients, after physical exertion or by the end of the day, there are weak pains in the spine area without a clear location. After rest they completely pass.

Thus, at the onset of the disease, all manifestations are nonspecific, so most patients do not seek medical help, explaining these symptoms with banal fatigue.

It is necessary to remember the following rule.

If the pain does not go away after taking anti-inflammatory or analgesic drugs, or the effect of the medication is insufficient or for a short time, then such pains are a sign of a serious illness that you yourself most probably do not cope.

When the tuberculosis process goes beyond the vertebrae (in case of spinal tuberculosis), the second phase beginstuberculosis of the spine. Weakness, lethargy, shattering intensify, high body temperature persists.

However, there are severe pains in this or that part of the spine. Because of the pain, the patient tries to move less, forming a violation of gait and posture. At rest, the intensity of pain either decreases, or they completely disappear.

The muscles located along the spine are constantly in a tonus, bulging, painful when feeling.

ATthe third phase of tuberculosis of the spineThe inflammatory process passes to the adjacent vertebrae. The general condition of patients is severe.

They significantly lose weight, body temperature rises to 39-40 degrees, there is a pronounced general weakness.

Due to constant stay in tone, the muscles along the spine atrophy, movements in the spine are greatly hampered or impossible.
After the treatment, the patients remain deformed in the spine, atrophy of the back muscles, and limited mobility.

Deformation of the spine with bone tuberculosis

Sandro Botticelli "The Birth of Venus detail, XV century. It is known that the model with which Venus was written died at the age of 22 from tuberculosis.

In the picture, the sharply lowered left shoulder attracts attention.

It can be assumed that the girl has a tuberculosis of the spine or shoulder joint.

In some patients, complaints remain about the sense of instability in the spine, pain in the area of ​​the affected vertebrae.

Developmenttuberculosis of the bones of the upper and lower extremitiespasses the same stages as tuberculosis of the spine.

Inflammation is accompanied by pain, redness of the skin and development of an edema over the area of ​​the lesion.

Due to the destruction of the bone, deformity of the limb, gait disturbance, up to lameness, decrease in ability to work.

Diagnosis of bone tuberculosis

All patients with suspected bone tuberculosis perform radiography or tomography of the affected organ in two projections. At the same time, foci of bone destruction, sequestration, and sometimes shadows from infiltrated abscesses are determined.

Radiography of the lumbar spine. The red circle shows typical bone damage in spinal tuberculosis.

In the presence of abscesses or fistulas, fistulography or abscessography is performed to determine their extent. The cavity of the abscess or fistulous course is filled with contrast medium, then a series of pictures is performed.

Very important for the diagnosis is the microbiological examination of the areas of the dead bone, the contents of the abscess or the fistulous course. In favor of tuberculosis of bones, the detection of mycobacteria of tuberculosis says.

In the blood test, all signs of infectious inflammation are detected: an increase in the number of leukocytes, accelerated ESR, the appearance of C-reactive protein, etc. To confirm the diagnosis, provocative tuberculin samples are also used.

Given the secondary nature of the disease, when suspected of tuberculosis bones, it is always necessary to perform chest X-ray, and in the presence of specific complaints, to conduct a survey and other bodies.

Treatment of tuberculosis of bones

Treatment for bone tuberculosis should be aimed at the prompt elimination of infection, prevention of bone destruction, as well as performing non-specific restorative treatment.

Diet for bone tuberculosis

In the active phase of inflammation in patients with tuberculosis, increased protein breakdown is observed. Therefore, for an early cure, it is necessary to increase the consumption of foods rich in protein.

The amount of food consumed should be increased by 1/3. The daily calorific value during the period of active inflammation averages 3100-3500 kcal per day.

At the same time, over-nutrition leads to overloading the body with unnecessary carbohydrates, obesity, and therefore is unacceptable.

With tuberculosis during the recovery period in the diet should be increased the content of milk and lactic acid products as a valuable source of calcium for the damaged bone.

In inflammation, as well as during the treatment with antibiotics, consumption of a large amount fresh fruits and vegetables, as well as medicines containing a complex of essential vitamins.

Lifestyle in the Treatment of Bone Tuberculosis

With an active inflammatory process, bed rest is recommended. In the process of recovery can be applied therapeutic exercise, massage.

The patient must spend as much time as possible in the open air, solar baths have a good effect.

As a rule, treatment and rehabilitation of such patients is carried out in specialized dispensaries and sanatoriums, where such a regime of day and rest is observed.

Medical and surgical treatment of tuberculosis of bones

The most effective treatment for bone tuberculosis is the combination of antibiotic therapy and surgical methods.

Antibiotic drugs are used before and after the operation. These drugs are rifampicin, isoniazid, pyrazinamide, ethambutol and others.

As a rule, these medicines are used together, for a long time according to a certain scheme.

The amount of surgical intervention depends on the degree of destruction of the bone, as well as the presence of abscesses, fistulas.

Surgical removal of sequestrants, cavities of abscesses and fistulous moves are washed with solutions of antiseptics, antibiotics.

Such cavities, with adequate treatment over time, are closed independently or liquidated by a surgeon.

Much more complex operations are performed in the late period of the disease with the development of gross anatomical disorders, significant defects. Such operations do not eliminate the disability of patients, but can significantly reduce its severity.

Rehabilitation after recovery should be phased.

Its main task is to fully restore the function of the affected organ and return the patient to normal life.

This applies therapeutic exercises, massage, physiotherapy methods of treatment, as well as various methods of professional and social rehabilitation.

Possible complications of bone tuberculosis

Possible complications of tuberculosis of bones include:
• rachiocampsis.

Pronounced curvature of the spine with bone tuberculosis

Often a hump is formed at the site of lesions of the vertebrae. This is often combined with secondary deformation of the chest. In this case, compression of the thoracic organs is formed.

With deformation of the spine, all patients develop a more or less severe disorder of the nervous system, ranging from an easy increase in muscle tone or involuntary movements, ending with paresis and paralysis.

• abscesses with tuberculosis of the spine are located next to the affected vertebrae. Can have a long extension. The only method of treatment is surgical.

• fistulas occur when the inflammatory process is released to the surface of the skin. At present they are rare.

Prognosis of development of bone tuberculosis

At present, the death rate from bone tuberculosis is close to zero. But this disease is characterized by a very severe course with the development of irreversible deformities of the bones, which leads to permanent disability.

It is established that patients become disabled in half of cases of spinal tuberculosis.

The treatment is long, many drugs are toxic, but only timely treatment for medical help and strict adherence to medical prescriptions will help prevent irreversible changes.

Prevention of bone tuberculosis

Common preventive measures include actions aimed at reducing the likelihood of meeting with patients with tuberculosis, as well as preventing hypothermia, injuries, intoxications.

Children and adolescents are advised not to refuse to conduct routine tuberculin tests, as this can help in the detection of latent forms of the disease.

Seeking medical help in the event of pain in the bones, muscles helps to recognize the disease in the early stages and effective treatment.

A source: http://www.medicalj.ru/diseases/orthopedics/964-tuberkulez-kostei

Bone Tuberculosis is an infectious disease

Bone tuberculosis is an infectious disease caused by the activity of tubercle bacilli, more commonly known as Kocha sticks.

Infection affects the bones containing a spongy substance, abundantly supplied with a vasculature, causing in the joint the formation of abscesses, long non-healing fistulas, impaired mobility, limb shortening or complete destruction the joint.

Tuberculosis of the spine leads to the formation of a hump, curvature of the back, and in severe cases, paralysis of limbs arises.

Three phases are distinguished during the course of the disease:

• primary osteitis (preartritic phase);
• Secondary arthritis (arthritic phase), including stages - the beginning, the heat, the fading;
• postartritic phase, which is the consequences of tubercular arthritis, its aggravation, prolonged course and relapses.

There are several forms of osteoarticular tuberculosis:

1. Tuberculosis of the knee joints - drives. This form of the disease accounts for about 20 percent of all cases of bone tuberculosis.
2. Tuberculosis of the hip joints is coxit. Most often occurs in children and in neglected cases leads to deformation and pathological dislocation of the hip joint.
3. Tuberculosis of the foot and ankle bones. It is accompanied by the presence of long existing caverns and fistulas. Often leads to the immobility of the joint due to the fusion of its surfaces.
4. Tuberculosis of the shoulder joints - omartrite. Quite a rare form of the disease, characterized by a prolonged course without exudation and purulent effusion.
5. Tuberculosis of the wrist joints. Also a rare type of bone tuberculosis, which is characterized by bilateral damage to the bones of the wrist or a combination with the pathology of other joints - knee or elbow.
6. Tuberculosis of elbow joints is a reindeer. More often affects young people under the age of 20 years. In the absence of treatment leads to persistent abscesses and fistulas.
7. Tuberculosis of tubular bones. Extremely rare type of disease, beginning in childhood. The main phalanges of the hand and metacarpal bones are more often affected.

Causes and ways of transmission

The source of the disease is a tubercle bacillus, which enters the body in various ways. Most often, infection occurs by airborne droplets, for example, after close communication with a tuberculous patient.

When this person coughs, sputum particles are spattered, containing a large number of pathogenic microbes.

Getting into the body through dirty hands or with food, microbes instantly carry the blood flow to all tissues and organs, including joints and bones.

However, it is not always possible to get mycobacteria into the body causing tuberculosis.

With healthy and developed immunity, microbes are not able to harm, since the body's defenses in time stop the onset of the disease.

Often, the beginning of the tubercular process is eliminated, without disrupting the general state of health, which occurs unnoticed for a person.

Adult people are less prone to the disease, because their immune system is strong and developed.

Most often, the tuberculosis of the bones affects the children's body, whose immunity is quite resistant to most infections.

Vulnerability of the child is increased after the transfer of such diseases as influenza, whooping cough and measles.

A sharp weakening of the protective forces, in the presence of pathogenic mycobacteria in the body, can act as a catalyst for the development of the tuberculosis process. For this reason, it is important to closely monitor the condition of the child after the infection. In the case of the slightest suspicion, it is necessary to consult a phthisiatrician.

It is important to know that the development of osteoarticular tuberculosis is facilitated by frequent overload of the locomotor system serious trauma, severe hypothermia, recurrence of general diseases and adverse living conditions and labor.

Symptoms of Bone Tuberculosis

According to statistics, tuberculosis of bones in children is more common than in adults. At an early stage it is rather difficult to recognize, because the disease begins gradually - developing imperceptibly without any special signs and sensations.

Many parents believe that the child falls ill after a severe bruise or fall, but this statement is fundamentally wrong. A common blow can not provoke the emergence of tuberculosis.

Its development after any injury is possible only in the case of an already existing tubercular focus in the bone itself.

Nevertheless, with close observation, the early stage of the disease can be identified. First of all, you should pay attention to the behavior of the child.

Irritability, lethargy, abandonment of moving games, absent-mindedness and fast fatigue can be the first signs of the disease.

In addition, a sudden stoop, limping, raised shoulders, clubfoot should be alerted.

Often the child can not jump on one leg, tries to step on it less, as a result of it slightly shrouding. It is worth noting that after a few hours of rest visible violations disappear, but after a while the problem repeats.

In an adult, the early phase of tuberculosis of the bones is very poorly expressed. Decreased performance, a sense of heaviness in the spine, low back pain, stopping after rest, are quite "blurred" symptoms, which not everyone will notice.

The most noticeable symptoms of bone tuberculosis, including tuberculosis of the spine, are on the second arthritic phase of the disease.

In this period there are severe pains in the joints and spine, similar to pain in sciatica, radiculitis and intercostal neuralgia.

Also there is a restriction of mobility of the joints, the muscles of the back become rigid and not elastic, resulting in stiffness of movements.

X-ray images clearly show such changes in the bone, as a narrowing or expansion of the joint crevices, uneven cartilage surface, cavities in the bone, lack of clear boundaries of the joints, thinning.

Among other things, clear signs of bone tuberculosis include limb shortening, abscess formation and muscle exhaustion.

Treatment

Early diagnosis and timely treatment of bone tuberculosis can avoid serious consequences. The process of recovery is always long and can take from one and a half to three years of continuous complex treatment.

First and foremost, it is important to provide the patient with peace and comfortable living conditions, which includes regular high-grade food, frequent outdoor activities and a good mood.

For patients with spine injury for the purpose of unloading and ensuring immobility, bed rest is prescribed in a plaster bed. When improving the condition, the patient is shown wearing a permanent gypsum corset, which is later replaced by a removable corset.

The term of orthopedic treatment depends on the availability of surgical interventions and the effectiveness of anti-tuberculosis drugs. The latter include: Streptomycin, Kanamycin, Rifampicin, Ftyvazid, Para-aminosalicylic acid.

These drugs delay the growth of tubercular microbes, thereby beneficially affecting the general condition of a person and contributing to the rapid decay of the tuberculosis process.

Such antibacterial therapy is conducted for at least a year.

Surgical methods of treatment are used for the final elimination of the tuberculosis process, as well as for restoring the motor abilities of the patient.

The type of surgery is selected by a specialist doctor, taking into account the location of the site and the degree of damage.

After attenuation of the disease and stable improvement of the condition, a smooth transition of the patient to a normal lifestyle is possible. In this case, it is necessary to remember the timely rest and harm of excessive physical exertion.

A source: http://www.knigamedika.ru/infekcionnye/tuberkulez/tuberkulyoz-kostej.html

Tuberculosis of bones and joints - the first signs in a child and adult, diagnostic methods and therapy

Tuberculosis of bones and joints affects the area of ​​the skeleton, localizing more often in the spine, less often involving large joints organism, its symptoms, as a rule, are little expressed and are revealed by diagnosing the state of the locomotor system apparatus. Treatment of the disease is long, requires an integrated approach with emphasis on strengthening the overall resistance of the body.

What is tuberculosis of bones

If the tubercle bacillus touches the spine or joints of the bones, the patient is diagnosed with osteoarticular tuberculosis.

This serious disease of the musculoskeletal system is caused by tubercle bacilli and leads to progressive destruction of the affected bones, their anatomical bending and functional violations. The localization of the disease distinguishes the types of tuberculosis:

1. spine - spondylitis;
2. the knee zone - chases;
3. the coxofemoral region;
4. Shoulder joints - omartrite;
5. the ulnar zone is a venison;
6. Ankle joints, foot;
7. ribs of the chest;
8. wrist, phalanx of the wrist, metacarpal bones;
9. tubular bones.

Tuberculosis is an infectious form of the disease caused by the causative agent - Koch's bacillus, and bone-joint damage is no exception.The organism becomes infected with tuberculosis by airborne droplets when coughing and through dirty hands.

Microbes from the primary site of infection are transported by the hematogenous channels (blood vessels, lymph) into tissues, bones, organs. However, not always getting the infection in the body is a sign of the onset of the disease.

A strong immune system stops the pathology, and weakened immunity can provoke the disease process.

Other factors influence the development of bone tuberculosis:

• physical overload of the musculoskeletal system;
• unbalanced nutrition;
• supercooling;
• injuries;
• adverse household situation;
• other infectious diseases;
• contact with the sick;
• severe working conditions.

Phases

The following stages of the course of osteoarticular tuberculosis are determined:

1. The first phase is preartritic. Forms tuberculous ostitis - the primary center. Among the tubercular granules formed, the part self-destructs, part is multiplying, connecting with each other. The focus is slow, asymptomatic.
2. The second phase is arthritic. This is the beginning, development and subsidence of arthritis. In the articular cavity pus accumulates, cartilage tissues die, the surfaces are bare. Fistulas and caverns are formed, a festering abscess develops. Joints are deformed, destroyed, the fusion of surfaces occurs, resulting in a limitation of mobility.
3. The third phase is postartritic. The consequences of arthritis are manifested by relapses, protracted course of tuberculosis. There is a loss of joint functions, up to immobility.

Forecast

The course of recovery is long, from, to 3 years of permanent complex treatment with the use of toxic medicines. Mortality due to the disease is almost zero, but tuberculosis of the joints and bones is very difficult.

The deformation of bones occurring in this case is in most cases not reversible, leads to the inability to work, to the disability of the patient.

Prevent pathological changes can be timely accurate diagnosis and obtaining medical care.

The disease is subject to any age. In children and adolescents, bone tuberculosis has a greater distribution than in adults and is characterized by significant impairment of the functions of the wounded region of the skeleton.

The initial stages, basically, pass without obvious symptoms, it is difficult to determine them without special diagnosis. Many do not attach importance to the feeling of heaviness in the spine, small articular pains that stop during rest.

The stage lasts from two to three weeks to several months.

First signs

Not everyone understands how to recognize such a disease as tuberculosis of joints and bones. Often patients, because of the uncertainty of the appearance of pain, take them as a result of fatigue.

When the pain symptoms do not stop after taking painkillers or anti-inflammatory drugs that give a short-term relief, then the pain signals the presence of a serious illness.

Children

Symptoms of the disease in children are more pronounced than in adults, manifested as autonomic disorders, drowsiness, lethargy, increased irritability, fatigue, lack of appetite, poor sleep, slight temporary increase temperature. Most often, children develop tuberculosis of the hip joint, which forms a pathological dislocation of the organ.In a child of younger age, osteoarticular tuberculosis may have signs similar to acute osteomyelitis.

In adults

The first symptoms of tuberculosis of bones and joints appear as follows:

• weakness, lethargy, decreased efficiency, drowsiness, fatigue;
• elevated temperature 37 ° С - 3, ° С;
• irritability;
• muscle pulling pain;
• night non-permanent painful sensations in the joint and in the spine without a specific location, disappearing after rest.

Diagnosis and treatment of bone tuberculosis

The disease has a secondary origin, it needs to be treated with a local effect and general prophylaxis, improving the body's health, aimed at enhancing its resistance. Therapeutic complex means:

1. Full nutrition with a clear regime and food ration. Patients with tuberculosis need to increase the consumption of milk, foods high in protein, sour-milk products, vegetables, fruits.
2. Well-organized life, psychological comfort, fresh air. Sanatorium and hydrotherapy, mud therapy are shown.
3. Antibacterial therapy. Preparations (para-aminosalicylic acid, ftivazid, rifampicin, kanamycin, streptomycin) take the course for a long time under a strict scheme.
4. Orthopedic treatment. Bed rest in the plaster bed is indicated in case of spinal cord injury, after which it is necessary to wear corsets, while limb tuberculosis requires a plaster bandage.
5. Surgical method. It is used with insufficient effect of drug treatment and rapid progress of the disease (joint resection, alloplasty, necrectomy, endoprosthetics).

A source: http://sovets.net/12571-tuberkulez-kostej.html

Tuberculosis of bones - symptoms, signs

Tuberculosis of bones is a disease in terms of the number of patients that is second only to pulmonary tuberculosis.

According to medical statistics, this diagnosis was confirmed in 20% of patients with extrapulmonary disease.

There are three stages in the course of the disease, each of which has its own symptoms:

• primary ostitis;
• secondary ostitis;
• postartritic phase, which is characterized by exacerbations and relapses.

For bones tuberculosis in adults at an early stage, the symptoms are almost invisible.

Somewhat reduced working capacity, there is a discomfort in the spine, there are weak pains in the back and limbs that pass after a short rest.

As a rule, people do not pay attention to such symptoms, and the disease passes to the next stage.

The pain is similar to that experienced by a person with intercostal neuralgia or radiculitis. At this stage, the muscles of the back lose their elasticity and impaired joint mobility.

Signs of tuberculosis can be seen on X-rays. Between the joints appear distances, the structure of the bone changes, the surface of the cartilage becomes uneven, cavities appear in the bone. Affected joints can be determined by the presence of tissue swelling or atrophy.

Causes of pathology

• The development of tuberculosis of bones is provoked by bacteria or, as they are also called, Koch's rods. They affect the bones inside which the spongy substance is contained, and through which the network of blood vessels passes. The result of the activity of pathogenic bacteria are non-healing abscesses, fistulas. The patient complains of impaired mobility of the joint. In the most severe cases, complete destruction of the bone and a decrease in its length are noted.
• In the event that the Koch sticks affect the spine, it can lead to complete paralysis, deformation of the spine, its curvature and the appearance of a hump.

The bacterium, the causative agent of tuberculosis, enters the body in various ways.

The most common method is airborne.

When sputum is allocated to a sick person, for example, when coughing, some of it settles on objects, surfaces or food.

In the body of a healthy person, they get through unwashed hands or food, and for a short time through the circulatory system are carried throughout the body, getting into all organs and bones.

But not all people get tuberculosis when they get into the body of pathogens. Many factors contribute to its development, the main one of which is immunity.

In a healthy person, the body's defenses cope with bacteria, and they do not harm the body.

However, if the body is weakened or the patient has recently had a serious illness, then the mycobacteria begin to develop in any organ and bones.

Also impetus for the development of tuberculosis of bones may be inappropriate living conditions, unsanitary conditions.

Among the causes of tuberculosis of bones, doctors distinguish:

• strong physical overload;
• trauma to bones;
• hypothermia of the body;
• frequent common diseases and relapses of old diseases;
• severe working conditions.

The first signs of illness

The first stage of the disease, depending on the patient's state of health, can last from several weeks to several months.

The first symptoms and signs of tuberculosis of bones:

• apathy to everything that is happening;
• drowsiness, fatigue;
• stable body temperature in the range of 37-3 degrees;
• decreased appetite and weight loss.

At the initial stage of the disease, patients rarely complain of problems with the musculoskeletal system.

In some cases, the first sign of tuberculosis of bones is aching pain in the joints and muscles, which appears at the end of the day.

With tuberculosis of the spine, the first sign of the disease is a constant aching pain. It is especially strong in standing position and passes if you change position or make several inclines to the sides.

Infectious or not, how is the disease transmitted

Annually, a few thousand people across the country diagnose bone tuberculosis of the bones, of which several hundred die. In this regard, it is important to know how the rods of tuberculosis enter the body and are contagious.

Infection with tuberculosis occurs quickly enough.

The bacterium enters the body, and after a while it spreads through the circulatory and lymphatic system throughout the body.

How is tuberculosis transmitted?

Tuberculosis can be infected in the following cases:

1. With close contact with the carrier of the tubercle bacillus. When using his household items or personal care products.
2. Airborne droplets from a nearby carrier of tuberculosis.

In order to prevent infection, doctors advise to follow simple rules. Namely: observe the rules of hygiene, wash food before use, do not use objects and personal hygiene products of a sick person.

Radiation diagnosis of the disease

Since the tuberculosis of the bones is similar in symptoms to a number of other diseases, most people seek help from a primary GP for help with a primary care physician.

It is from his qualification and properly assigned diagnosis that the timeliness of the initiated treatment, and sometimes, the life of the patient, will depend.

Since tuberculosis is characterized by a change in bone structure and depends on the state of immunity patient, the best way to identify it is to use one of the radiation diagnostics.

Necessity of appointment by a doctor of radiography

X-rays for many years can diagnose many diseases that are not visible to the human eye.

This method of diagnosis is not accompanied by pain and is accessible.

On an X-ray, bone patches affected by tuberculosis are visible as dark spots.

You can also see the change in the distance between the joints or their fusion.

In this case, thinning or formation of cavities within the bone, presence of abscesses in the tissues, around the affected bone is revealed.

Magnetic resonance imaging

MRI diagnostics allows you to observe the dynamics of the course of the disease. Based on the results of this conclusion is given about the presence and size of paravertebral abscesses, the state of intervertebral discs and canals, the spinal cord and its membranes.

MRI is not used to diagnose patients with established metal parts in the spine or locomotor apparatus, heart rhythm apparatus.

Computer tomogram in a clinic

This type of diagnosis is successfully used to detect the disease at an early stage. The advantage of this method before radiography is that it allows you to determine the degree of damage to bone tissue, as well as the nature of the disease.

With the help of a computer tomogram, it is possible to diagnose not only the main bones, but arches and processes that can also be affected by the disease.

Changes in laboratory analyzes

Another method of diagnosing bony tuberculosis is laboratory research. These studies are the same for all forms of tuberculosis and are used if other diagnostic methods can not give an unambiguous answer about the presence of the disease.

Bacterioscopic examination rarely reveals the presence of tuberculosis bacteria in the test material. For their detection, a cytological study is used more often.

The material is sampled by the method of bone marrow puncture, lymph nodes, joint fluid, bone and soft tissues. The disadvantage of this method can be its unreliability in the event that it is impossible to take a normal material intake because of the limited space.

With bone tuberculosis, as well as its complications, for example, abscesses or fistulas, a detailed blood test shows an elevated level of ESR and neutrophilic leukocytosis.

Tuberculosis of the spine

Extrapulmonary spinal tuberculosis or Sweat disease refers to infectious diseases and has a number of characteristics. Most often it affects the upper thoracic and cervical divisions, and is more likely to be diagnosed in men.

Tuberculosis of the spine for a long time is asymptomatic, so it is almost impossible to diagnose it in the early stages.

Initial signs do not clearly indicate tuberculosis of the spine. Often they can be confused with the symptoms of other diseases.

For the early stage are characterized by such signs:

• constant feeling of indisposition;
• fast fatiguability;
• loss of body weight and appetite;
• for children is characterized by a loss of interest in mobile games and games in the open air;
• in the evening and night time there is an increase in body temperature.

Among the local signs in patients there is pain, spasm. There are often complaints of stiffness of the movements, less often of acute pain in the spine.

A true sign of the presence of spinal tuberculosis in a person is a change in his gait.

She becomes insecure and shaky. The distance between steps is reduced, the person is difficult to move around and keep his balance.

At the transition of the disease to a later stage, the external signs of the disease become the following:

1. there is awkwardness of gait;
2. for movement, support is required, muscles lose their former strength;
3. part of the muscles atrophy, and the patient can not move independently or get up from the surface of the bed, chair.

When choosing a method for treating spinal tuberculosis, it should be borne in mind that the main objectives of therapy are to increase immunity to fight the disease and restore the functionality of the spine.

Therapy is chosen based on:

• the response of the body to the infection that has entered into it;
• degree and form of the disease;
• duration of the disease and age of the patient;
• the state of the lymphatic system and all internal organs.

The main method of treatment is sanitary and hygienic. It combines products rich in vitamins and trace elements, observance of the correct regime of the day, psychological help to the patient.

Not the last factor in the treatment is the natural climate in which the patient is. When using the local orthopedic method of treatment, a certain goal is put at the head.

For a patient who retains motor activity, this is to ensure rest and reduce the burden on the spine.

The use of chemotherapy for the treatment of tuberculosis had a number of positive aspects.

This allowed almost completely to avoid deaths due to illness, reduced the likelihood of complications and accelerated the recovery of patients.

It is also noted that after the chemotherapy course it is possible to restore the function of the spine almost completely.

How to treat this pathology

To cure such a serious disease as tuberculosis of bones and joints will take a long time, depending on the patient's condition from, to 3 years, and a comprehensive approach to the problem.

In the early stages, it will be sufficient to direct efforts to increase the defenses of the body and unload the affected bones and joints.

Rest and unloading of affected organs is provided in various ways, for example, by imposing gypsum or tires on the limb, wearing a corset with a spinal injury or bed rest before the end treatment.

At later stages, antibiotic therapy is used for treatment, often in combination with chemotherapy.

It helps to cope with the multiplication of microorganisms and their spread.

Further, if the immunity of a person is sufficiently strong, the disease fades, and a full recovery comes. If antibacterial agents do not give the desired effect, then they are used in combination with hormonal agents and chemotherapy.

Operative treatment is used to shorten the period of treatment and complete restoration of joint function. It is used at any stage of the disease, on any bone or joint, regardless of the location and spread of the foci of infection.

Possible complications of bone and joint damage, prevention of

For tuberculous lesions of bones and joints, a number of complications are typical, which experts attribute to:

• compression of the spinal cord due to deformation of the vertebrae;
• the occurrence of abscesses and sagging, and in places not located near the lesion;
• violation of gait, posture, appearance of a hump;
• destruction of bones and vertebrae;
• partial or complete loss of joint function;
• changes in degenerative and dystrophic nature;
• osteochondrosis.

In order to prevent the emergence of tuberculosis of bones or to prevent the course of the disease in severe form, it is necessary to carry out preventive measures:

1. Be physically active. Playing sports and moderate physical activity contribute to the strength of bones and prevent the onset of the disease.
2. Strengthening the body's immunity in order to increase its resistance to disease.
3. Vaccination against tuberculosis.
4. Periodic examination for the presence of a tubercle bacillus in the body.
5. Reduced frequency of communication with patients with tuberculosis.
6. Proper adherence to all hygiene rules.

Experts note a good result in the prevention of the disease, which is achieved by a special diet containing vitamins and all the necessary substances. Also of great importance are living conditions and everyday life.

Tuberculosis of bones is a serious disease, but with timely diagnosis it is successfully treated, bones and joints restore their functionality after a while.

A source: http://FeedMed.ru/bolezni/oporno-dvigatelnoi/tuberkulez-kostej-simptomy.html