Bones and joints, tuberculosis

Bones and Joints, Tuberculosis

A bacterium called Mycobacterium tuberculosis  is known to be the main cause of the diseases TB. This disease is usually known to attack the lungs but in some rare cases it can further spread to the bones. Tuberculosis is preventable, and if it's contracted and found early, it's for the most part treatable.

TB principally influences the lungs, however now and again it can spread to different pieces of the body. At the point when TB spreads, it's alluded to as extrapulmonary tuberculosis (EPTB). One type of EPTB is bone and joint tuberculosis. Bone tuberculosis is essentially a type of TB that influences the spine, the long bones, and the joints.

Symptoms that indicate Tuberculosis (TB)

All things considered, when a patient has contracted bone TB there are a few indications to look out for:

  • serious back pain
  • growing
  • firmness
  • abscesses

At the point when bone tuberculosis is further developed, some hazardous side effects include:

  • neurological difficulties
  • paraplegia/loss of motion
  • appendage shortening in kids
  • bone disfigurements

How is it transmitted?

When the tuberculosis bacteria start expanding its branches and spreads out of the lungs it can cause bone and joint tuberculosis.  Tuberculosis is ordinarily spread from individual to individual through the air. After you contract tuberculosis, it can go through the blood from the lungs or lymph hubs into the bones, spine, or joints. Bone TB regularly starts because of the rich vascular inventory in the long bones and the vertebrae.

Bone tuberculosis is generally uncommon, however over the most recent couple of many years the pervasiveness of this disease has expanded. While rare, bone tuberculosis is hard to analyze and can prompt extreme issues whenever left untreated.

How to diagnose bone and joint Tuberculosis?

Methods for diagnosing bone and joint tuberculosis include:

Aspiration of fluid in the joint: Confirmation of the diagnosis is obtained by aspiration of joint fluid. Acid-fast stains are positive in 20–25% of samples of joint fluid, and M. tuberculosis is isolated in approximately 60–80% of them.


Biopsy of the joint to detect the bacteria that causes TB: Biopsy specimens of synovium or bone have a higher yield and enable histologic examination. More recently, the use of Xpert MTB/RIF for diagnosis of bone and joint TB demonstrates good diagnostic accuracy irrespective of the type of specimen sampled. 


Chest x-ray: In a chest X-ray, electromagnetic radiation forms an image of the organs in your chest, such as your heart and lungs. An X-ray can detect damage in the lungs, which may indicate tuberculosis. 


CT scan:  CT scan is particularly useful for evaluating the degree of bone destruction, sequestrum formation (although rare), and surrounding soft tissue extension. CT scan may be helpful for the detection of osseous or joint involvement, the presence or absence of periosteal reaction and soft tissue calcifications, sclerosis, and soft tissue abscesses. USG and CT scan are particularly useful for guiding fine needle aspiration or biopsy to provide material for histopathological examination, PCR-based assay for mycobacterial DNA, and culture.


Joint x-rays: The commonly observed features on X-rays in spinal TB are loss of vertebral height, indistinct vertebral endplates, erosions, angular kyphosis, and paravertebral masses. Involvement of two or more contiguous vertebrae generally occurs later. In appendicular skeleton, Phemister’s triad of juxta-articular osteopenia/osteoporosis, peripheral osseous erosions, and gradual joint space narrowing suggests tuberculous arthritis but is nonspecific


Tuberculin skin test (also called PPD): A purified protein derivative (PPD) skin test is a test that determines if you have tuberculosis (TB). TB is a serious infection, usually of the lungs, caused by the bacteria Mycobacterium tuberculosis. This bacteria spreads when you breathe in the air exhaled by a person infected with TB.


MRI: MRI of the spine is considerably more sensitive than routine radiographs and should be obtained when there is a high index of suspicion of an infectious process. MRI can diagnose a tuberculous bone lesion with 100% sensitivity and 88% specificity, allowing for diagnosis before deformity develops. 


Polymerase chain reaction (PCR) test: The samples that your doctor takes can also be tested using PCR. This test boosts the genetic material of the mycobacterium and helps look for infection from small amounts of fluids.‌

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