A Comprehensive Guide for Patients Fighting Bone Tuberculosis

Pulmonology | by Dr. Raja Dhar | Published on 14/11/2023

Introduction

Humanity has been distressed by tuberculosis in its pulmonary form, for centuries. However, a lesser-known but no less important facet of this contagious disease is its impact on bones.

Mycobacterium tuberculosis is the primary cause of bone tuberculosis, the same bacteria causing pulmonary tuberculosis. It is also known as skeletal tuberculosis or Pott's disease. Bone tuberculosis is a chronic and harmful contagion. Even though bone tuberculosis is not a common infection, it still showcases particular challenges and healthcare professionals. 

If you have symptoms like bone deformities or neurological complications, book your appointment with the expert pulmonologists in Kolkata at the Calcutta Medical Research Institute. They will ensure a proper diagnosis and treatment options suitable for your condition.

In this blog, we will cover the important aspects of bone tuberculosis, so make sure to stay tuned till the end. However, kindly note that this blog is research-based, and we do not encourage overlooking the pulmonologist’s consultation in any way. 

What is Bone Tuberculosis?

A rare form of tuberculosis affecting the bones is known as bone tuberculosis, sometimes also called skeletal tuberculosis or tuberculous osteomyelitis. The primary cause of this type of tuberculosis is Mycobacterium tuberculosis. It is a bacterial contagion that impacts the lungs (pulmonary tuberculosis). However, it can move to other body parts including the bones via the circulatory systems and lymphatic.

Usually, the typical cause of bone tuberculosis is hematogenous transmission (bloodborne) of the bacteria from another infected area in the body. This condition affects several bones, primarily, the spine including other skeletal structures. 

What are Bone Tuberculosis Symptoms?

Bone tuberculosis symptoms can be mild initially and may appear slowly in time. Here are some tuberculosis symptoms could be:

• Pain: Persistent and frequent chronic pain is one of the most common symptoms of Bone TB in the affected bone or joint. The pain tends to get worse over time.
• Swelling: Joint deformities are noticeable in certain cases including swelling around the injured bone or joint. 
• Stiffness: Patients can experience a reduction in joint mobility including stiffness as the condition worsens which makes it difficult to move the affected joint. 
• Limitations in joint range of motion: It becomes challenging for patients to move in all directions as the condition begins to damage the joint. 
• Tenderness: Joint or bone pressure might cause pain and the afflicted area feels tender while the patient tries to touch it. 
• Warmth: Due to inflammation caused by bone tuberculosis, the skin over the injured area feels warm. 
• Fever: Low-grade fever is one of the side effects of bone TB. 
• Sweating at night: Sweating at night is a sign that should not be overlooked. 
• Weight loss: A constant infection like tuberculosis is the main cause of a baffling decline in body weight.

What are Bone Tuberculosis Causes?

As per healthcare professionals, mycobacterium tuberculosis is the primary bone tuberculosis cause. Here are some of the following factors that cause the emergence of bone TB: 

• Primary infection with tuberculosis: Hematogenous (bloodborne) spread of Mycobacterium tuberculosis from a primary tuberculosis infection area, often in the lungs, is identified as the primary cause. 
• Weak immune system: People suffering from HIV/AIDS, malnutrition, or other immunosuppressive illnesses, or having weak immune systems in general, are prone to develop bone tuberculosis. The body finds it challenging to prevent the bacteria from spreading when the immune system is jeopardized.
• Close contact with patients affected by tuberculosis: There is a great probability of catching the infection if one is near someone suffering from pulmonary tuberculosis. 
• Age: Children and young adults, particularly those who are below sixteen, are vulnerable to contract bone tuberculosis. However, it can also affect old age group people.
• Malnutrition: Vitamin D deficiency and poor diet lead to weak bones and increase the risk of infection.
• Prolonged Infection: Bone TB usually advances gradually and covertly. Before it shows symptoms, the bacteria lie inactive in the bones for a long period. It makes diagnosis and treatment difficult.
• Immunization: The absence of enough bacillus calmette-guerin or BCG vaccination also makes people susceptible to tuberculosis. 
• Genetics: An individual is vulnerable to developing the infection if she/he has particular genetic attributes. 
• Coexisting conditions: Severe renal failure and diabetes are conditions that increase the probability of developing bone tuberculosis.

How is Bone Tuberculosis Diagnosed?

Bone tuberculosis, also called skeletal or osteoarticular tuberculosis, is often diagnosed by a healthcare professional team involving the use of imaging studies, laboratory testing, clinical assessment, and medical history. Here are the standard procedures for bone TB diagnosis:

• Clinical Evaluation: It involves a comprehensive clinical history and physical evaluation by a healthcare expert. They will identify signs and symptoms like swelling, joint pain, etc. indicating the presence of tuberculosis infection. 
• Imaging Studies: Several imaging tests like X-rays, CT scans, and bone scintigraphy are involved in diagnosing bone tuberculosis. 
• Lab tests: This test involves a tuberculin skin test or Mantoux test, interferon-gamma release assays, and microbiological tests. 
• Histopathological Examination: It helps in identifying the existence of mycobacterium tuberculosis. 
• Blood tests: These tests involve examining ESR and C-reactive protein to identify the active infection. 

What are treatment options for bone tuberculosis? 

Bone tuberculosis treatment often involves combining antibiotics and surgical intervention if needed. Here are some options usually recommended by a healthcare professional to treat bone TB:

• Antitubercular medications: These drugs are often prescribed for six months. It helps in alleviating the bacteria that cause the infection. The treatment duration and drug regimen depend on the patient's condition and infection complexity. 
• Surgical intervention: In certain cases, surgery might be necessary to deal with structural damage complications by bone TB. Some surgical options include debridement, abscess drainage, joint reconstruction, and bone grafts. 
• Supportive care: Patients might often need treatment options to manage pain, orthopedic support, physiotherapy, etc. to preserve joint function and diminish pain while healing is in process. 
• Monitoring and follow-up: Regular follow-up appointments with healthcare experts are important to evaluate the patient’s improvement, assess medicine side effects, and modify the treatment plan as per the requirements.

Takeaway

Bone tuberculosis is not very common but is a serious condition that can hugely affect a person's quality of life. In this write-up, we have discussed its causes, symptoms, diagnosis, and available options for treatment. It's crucial to identify the symptoms and risk factors of bone tuberculosis, but it's also vital to understand that the condition is curable with early diagnosis and the right medical attention.

FAQ -

 

Is bone TB curable?

Yes, bone TB is curable with early detection and proper medical attention. 

Is bone TB contagious?

Bone TB is not contagious until the person doesn’t come into contact with the patient’s pus. 

Can bone TB spread to others?

Bone TB cannot spread to others through the air but an individual can get affected through blood if unaffected ones come into contact with the bodily fluids.