You can get sick with bone tuberculosis due to poor living conditions, physical overwork, injury, recurring infectious diseases, hypothermia, poor working conditions.
Main provocateur
Decisive in the development of such a disease as bone tuberculosis is previous contact with a person affected by this disease. The disease is the result of the penetration of mycobacteria from the focus of tuberculosis in the lungs through the blood and lymphatic vessels into the bones. 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 the disease progresses
With the active reproduction of mycobacteria, the formation of specific tubercles of granulomas occurs, which are subsequently destroyed. As a result, tuberculosis of the bone marrow develops. The bone substance undergoes dissolution, abscesses of the cavity appear, filled with purulent contents, fistulas, characterized by the absenceconnections between bone and the environment. There are also torn areas of dead bone (sequesters).
How tuberculosis of the spine manifests
Bone tuberculosis of the spine begins its development in one vertebra. With the growth of granulomas, rarefaction of bone tissue occurs, inflammation captures neighboring sections of the spinal column. The spine is deformed. With damage to the thoracic region, when the spinal cord is squeezed, paralysis and paresis can form.
Symptoms of bone tuberculosis
Bone tuberculosis at the initial stage is characterized by a weak manifestation of symptoms. They may not show up at all. Patients complain of a slight increase in temperature up to 37 degrees. Sometimes the temperature rises even higher. Children become lethargic and drowsy, and adults feel asthenic nervousness and pulling pains in the muscles. The performance drops sharply. Some people after exercise feel moderate pain in the spine without a clear localization. After 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 is not stopped when taking analgesics or anti-inflammatory drugs, then they signal the presence of the development of such a disease as tuberculosis of the skeletal system, which you can cope with on your ownimpossible.
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 characterizes the second stage
Asthenia intensifies, body temperature rises to high levels. Along with this, there is severe pain in one or another part of the spine. This pain restricts a person's movement. His posture and gait are disturbed. At rest, the intensity of pain decreases. The muscles along the spinal column are in tension, swell. The patient feels pain on palpation.
Third stage of tuberculosis
Bone tuberculosis affects neighboring vertebrae. The general condition of the patient is characterized as severe. A sick person loses weight significantly, body temperature is kept at around 39 or 40 degrees. The asthenic state is preserved. Pain in the spine are intense. At rest, they decrease somewhat.
After the treatment, the patient's spine remains deformed, atrophy of the spinal muscles is observed, and a person's mobility 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 in spinal tuberculosis. What are the signs of bone tuberculosis of the extremities? The inflammatory process is characterized by pain, the skin turns red, and swelling is noted over the affected area. Bone destruction provokes limb deformity and gait disturbance up to the appearance of lameness. Employability drops sharply.
How the disease is diagnosed
All patients with suspected bone tuberculosis undergo X-ray or tomography of the affected organ in two projections. In this case, it is necessary to determine the focus of bone destruction (sequesters) and shadows from abscesses.
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 a contrast agent, then a series of images are taken.
When making a diagnosis, microbiological examination of areas of dead bone, the contents of an abscess or fistula plays a crucial role.
Indicating bone tuberculosis
Bone tuberculosis confirms the presence of mycobacteria. A blood test indicates an inflammation of an infectious nature. 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 may be secondary, it is necessary to undergo a chest x-ray, and if there are complaints of a specific nature, an examination of other organs.
How is tuberculosis of the bones treated
Bone TB, which takes a long time to heal, is eliminated by stopping the infection as soon as possible. It also prevents the destruction of bone tissue. Restorative treatment is being carried out.
Dieting
In the active period of the inflammatory process, the patient has 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. The daily calorie content should be 3500 calories per day. At the same time, excessive nutrition leads to overload of the body and obesity, which is unacceptable for 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 with eggs.
The diet should be supplemented with milk and lactic acid products. They contain calcium, which is essential for damaged bone.
In the inflammatory process, as well as during the course of antibiotic treatment, it is recommended to consume a large number of fruits and vegetables, as well as multivitamin complexes.
Lifestyle when ill
With advanced inflammation, bed rest is recommended. In the process of treatment, physiotherapy exercises and massage can be applied. A sick person should often stay in the fresh air. Sunbathing has a beneficial effect. As a rule, patients undergo treatment and rehabilitation courses in specialized dispensaries and sanatoriums, where the daily regimen is strictly observed andrest.
Treatment of the disease with medicines
Antibiotic treatment with a combination of surgical methods has the greatest effect.
Antibacterial drugs are used both before and after surgery. Usually, doctors prescribe "Rifampicin", "Isoniazid", "Pyrazinamide", "Ethambutol", etc. Medicines are used for a long time. They drink according to a certain pattern.
Surgery
The amount of surgical intervention depends on how much the bone has been destroyed, as well as the presence of abscesses and fistulas. It is possible to remove sequesters, abscess cavities and fistula passages by the operative method. They are washed with antiseptics and antibiotics. Such cavities, with proper treatment, close themselves.
Much more complex operations differ at a late stage of the development of the disease with a gross deformity in the spine and bones. Such operations cannot eliminate the disability of patients, but they 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 that contribute to social and professional rehabilitation is shown.
Complications
Bone TB can cause a number of complications:
- Curvature of the spinal column. At the site of injuryvertebrae often there is a hump. This often results in secondary deformation.
- When the spine is deformed, all patients experience 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 may be of great length. The only treatment is surgery.
- Fistulas occur at the outlet of inflammation on the surface of the skin.
Prognosis of the development of the disease
Currently, death is almost non-existent. But this disease is characterized by a very severe course with the appearance of deformations of an irreversible nature, which leads to disability. It has been established that in about half of the cases people become incapacitated. Treatment is lengthy and many drugs are toxic.
Preventive measures
General preventive measures are measures aimed at reducing the likelihood of contact with tuberculosis patients, as well as preventing infectious, colds, injuries and poisoning.
Children and adolescents should be routinely tested for TB as this helps in detecting latent disease. Seeing a doctor if you experience pain in the bones and muscles helps to recognize the disease in the early stages and provide timely effective treatment.
Bone tuberculosis in children
Adulta person has a greater resistance to tuberculosis, since his immunity is stronger and more developed. The child's body is more weak. Therefore, tuberculosis of the bones and spine often occurs in childhood.
Cause of infection in childhood
Under the influence of adverse conditions, the child's body quickly becomes vulnerable to microbes.
Acute infectious diseases are also fertile ground for the development of tuberculosis. These include influenza, measles and whooping cough. They contribute to the weakening of the protective forces.
TB microbes in the body of a child who has recently had an infectious disease easily provoke the development of bone and joint damage. Therefore, parents should be attentive to the baby who has had severe infections, and at the slightest suspicion of tuberculosis, show him to the doctor. The specialist will prescribe the appropriate examination.
How does bone tuberculosis begin in a child
Most often, bone tuberculosis in children develops latently and slowly. Often the child complains of pain in the joints.
Some parents attribute the onset of illness to a fall or bruise. But this judgment is fundamentally wrong. Without a painful focus in the bones, tuberculosis cannot develop from a simple fall.
What complications can cause bone tuberculosis in a child
If a child is not given timely medical care, then tuberculosis can provoke an abscess in the joint and the appearance of fistulas that do not heal for a long time. joint diseasecan cause its destruction and impaired mobility, shortening of the limb. Tuberculosis of the spine causes its curvature, the formation of a hump and paralysis of the limbs.
With 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 bone tissue degeneration. At this time, the patient can notice clear signs of the disease. Both the joint itself and the general condition of the child's body can signal an illness.
Symptoms
How does bone tuberculosis manifest itself in a child? The symptoms are varied. First of all, a change in the mood of the child should alert. Once cheerful and cheerful, he is transformed, becomes lethargic and apathetic. Dramatically loses weight, turns pale, suffers from poor appetite, does not run, gets tired from walking, often rests, leaning his back against the wall. Among the neurological signs can be noted absent-mindedness, fatigue, restlessness.
Often, parents note that the child has become immobile and prefers rest to activity. Sometimes a child's temperature rises 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, a stoop or excessive straightness of the spine is noted. In this case, the shoulders are raised up, and the neck or head is held crooked.
Sitting down, the child leans his hands on the chair, and if he wants to bend his back, he produceshands on knees. When the joint is damaged, he begins to drag his leg. Clubfoot is often observed. The child tries not to step on the affected leg.
Much less often, osteoarticular tuberculosis debuts with mild lameness. Parents think that the child is playing around and scold him. For a while, his gait and posture straighten out, but then everything returns. If the hand is affected, then the child instinctively protects it, making a movement only with a he althy hand. At the same time, there are no complaints of pain. These phenomena are caused by a reduction in the normal mobility of the joint 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, limitation of mobility will be observed again, 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 noted 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 composition, the knees are disturbing.
When the spine is affected, grunting may be noted when breathing. Sometimes a child screams at night from pain during careless movements duringsleep.
It is very important to catch the very first symptoms and see 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 heal the spine or large joints in childhood.
The sooner the presence of the disease is detected and appropriate treatment is started, the better the outcome of the disease will be.
