Bone tuberculosis is an acute progressive disease with a strong destructive character. This type of disease is accompanied by active inflammatory processes. As a result of the disease, deforming processes of the musculoskeletal system begin.
What is this disease?
Tuberculosis of bones and joints is infectious and is provoked by Koch's wand. The primary focus is formed at the moment of penetration of the tubercle bacillus into the bones, into its spongy sections. Further, as the disease develops, it captures nearby cartilage and joints, leading to destructive processes in bone tissue.
The disease most often affects areas that have the most bone marrow, such as the spine, hip, elbow and knee joints. In the event that there is no timely, properly selected treatment, bone tuberculosis leads to very serious complications. Among them, shortening and even muscle atrophy, partial or complete immobility of the joints, the formation of a hump, deformity of the spinal column.
Bone tuberculosis in adults has three phases of development:
- appearance of a primary focus;
- development and extinction of secondary arthritis;
- flare-ups and relapses.
Reasons
The causes of bone turbeculosis can be various factors individually, as well as their combination.
Main causes of this disease:
- Joint or bone injury. At the same time, the likelihood of developing this disease will directly depend on the quality of recovery of the injured joint.
- High stress on the body, especially with improper nutrition or metabolic disorders, can lead to incomplete recovery after injury.
- Infectious disease can have a deplorable effect on the condition of the bones.
- Decreased immunity level.
- Unfavorable living conditions.
- Lack of vitamins and minerals.
- Stress.
Mainly the development of this disease begins after the so-called Koch sticks enter the body. From this moment, symptoms and signs of bone tuberculosis begin to appear. If the human body is not weakened, then these bacteria cannot harm it. If, on the contrary, then active division and reproduction of tuberculosis bacteria in the tissues begins. The rate of division depends on the method of treatment and the condition of the body as a whole.
Symptoms and signs
Bone tuberculosis is a life-threatening and he alth-threatening disease. Its nature is to change the structure of bone and cartilage tissue, damage to skeletal muscles, abundantsuppuration. It should be noted right away that the first signs of the abscessive process should be noticed by relatives and friends of the sick person and take this symptom seriously, since Koch's wand and its derivatives are very contagious.
Symptoms and first signs of tuberculosis of bones and joints:
- slight increase in body temperature;
- joint aches (arthralgia);
- weakness of the knee muscles, difficulty in flexion and extension of the arms;
- changing gait;
- redness and swelling in the affected area;
- appearance of pustules, pustules on the skin;
- fistula formation;
- destruction of bone and cartilage tissue;
- changing the shape of the joint bag (at later stages).
Carrying out diagnostic measures, the radiologist will immediately notice multiple spots in the picture in the area of large tubular bones and joints. They will be an indirect confirmation of the diagnosis. It is possible to accurately determine the presence of tuberculosis only with the help of specialized blood tests that detect specific antibodies to Koch's bacillus. The symptoms of tuberculosis of the bones and joints themselves are not sufficiently informative.
Phases of the tuberculosis process
The first phase is called primary osteitis (focal). The second - progressive, it is divided into two stages:
- development of uncomplicated osteitis,
- complete destruction of bone and articular segments.
The third phase is called metatuberculous osteoarthritis.
First phase
Tuberculous granuloma begins to form directly in the spongy viscera of the bone structures. In the primary lesion grows slowly, this phase may proceed without symptoms.
Second phase
Microorganisms begin to spread to the articular segments. Symptoms of tuberculosis of the bones begin to appear as follows. First, the synovial membranes will be affected. The cavities of the joint will begin to accumulate pus, the cartilaginous tissues of the joint will begin to die off and its entire surface will be exposed. The second stage begins with necrosis of the articular bags, the formation of fistulas and the development of abscesses. The appearance of deformation of the joints is noted, their mobility decreases, the length of the arms and legs changes.
Third stage
All inflammatory processes disappear, while the joint completely and irrevocably loses functionality. This stage ends with complete and irreversible destruction of the articular system.
Diagnostic procedures
Bone tuberculosis is diagnosed by clinical, radiological and laboratory examinations. First of all, the disease is diagnosed based on the characteristic clinical picture and patient complaints. Through X-ray examination, the disease is confirmed and the extent of the lesion is specified. Treatment is prescribed. Next, the attending physician monitors how the disease proceeds.
During a visual examination, pay attention to the position of the affected part of the skeleton, the density of the articular bag, the color of the skin, swelling,muscle tone, the presence of pain. The affected limb is differentiated from a he althy one in order to determine what changes are present. The doctor also checks the mobility of the joint.
Laboratory methods for diagnosing a disease include: bacteriological, histological and cytological examination of the patient's biomaterial, which is taken by puncture or biopsy.
In the process of laboratory research, a study of the leukocyte formula, ESR and other blood characteristics is carried out.
Tuberculosis is rarely detected during bacterioscopic analysis. The main preference is given to cytological analysis, but this is not always informative. In the case of limited pathology, the site most likely will not fall into the contents of the puncture. An open biopsy is taken only when the diagnosis is in doubt.
MRI, myelography, contrast-enhanced CT are also used to verify the diagnosis.
Diagnosing with x-rays
The main and earliest symptom of articular tuberculosis, which shows an X-ray examination, is osteoporosis of the bones. This process affects the entire bone, and not just the area where the pathology is actively developing. X-ray information shows each stage of the disease, but the development of symptoms is difficult to detect in the early stages, especially in patients of advanced age due to a decrease in joint mobility and bone density due to natural causes.
X-ray resultsexaminations perfectly reflect the following symptoms:
- Narrowed joint spaces.
- Irregular cartilage surface.
- Presence of voids in the bones.
- Lamination of intermuscular spaces, which appears as a result of edema.
If there is a tuberculous abscess, the image will show a shadow near the pathological area.
Medicated treatment
Treatment of osteoarticular tuberculosis requires an integrated approach:
- medical;
- individual;
- traditional.
As part of a conservative therapeutic approach, the treatment of bone tuberculosis is done with medicines.
Their list includes:
- Mycin preparations (active substances - streptomycin, kanamycin, capreomycin, viomycin). They actively fight against the inflammatory and parasitic process, help to cope with the deformation of cartilage tissue, and have a beneficial effect on already changed tissue structures.
- "Ethambutol", "Pyrazinamide" are specialized drugs that act on the Koch stick. They are able to completely suppress the further spread of the infection, stop the negative impact of the disease.
- Fluoroquinolones. This is a group of drugs that partially or completely restore damaged bone, cartilage, muscle tissue. The degree of their impact depends on the form of tuberculosis and the duration of the disease.
- Antihistamines. Since the decrease in immunity is due to the aggressive attack of foreign agents, maintenance therapy is prescribed. drugs,reducing sensitivity, help the body to more actively resist pathogenic bacteria and viruses.
- Angioprotectors ("Actovegin", "Trental", etc.). Restore the lost part of the bone and cartilage tissue of the joints. Helps restore mobility lost due to bone tuberculosis.
- Antioxidants (vitamin E, sodium thiosulfate). The removal of toxins, metabolic products and bacteria is one of the most important steps in getting rid of the disease. Antioxidants capture harmful substances and naturally remove them from the body.
Surgical treatment
Surgical treatment of bone tuberculosis varies depending on the characteristics of the development of the disease, but in any case, this type of treatment is the most traumatic. This type of treatment is usually prescribed at the last stage of the disease, when physical therapy is no longer able to restore a large amount of destroyed bone and muscle tissue.
The following types of surgical intervention are distinguished:
- Removal of destroyed tissues in the area of periarticular and extraarticular lesions.
- Complete removal of foci of infection.
- Removal of the synovium of the joint.
- Removal of articular surfaces and cartilage.
- Removal of a pathological focus in a certain bone.
- Extra-articular resection within he althy tissue.
- Removal of abscesses.
There are also a number of auxiliary operations aimed at restoring the functions of the joints:
- Operations,aimed at restoring mobility in the joint.
- Operations aimed at restoring bone tissue.
- Implantation of artificial joints.
The choice of the type of operation will depend on the phase and stage of the disease.
Folk treatments
The cause of tuberculosis is Koch's bacillus. It has a high resilience. To get rid of this disease, some folk methods of treating bone tuberculosis have proven themselves well. However, it must be remembered that the decision to treat in this way should be considered. It is necessary to weigh all the pros and cons, analyze the situation, consult with your doctor, because bone tuberculosis is a disease that develops very quickly and can cause serious complications if the treatment is not chosen correctly.
Do not forget that the treatment of such a serious disease with folk methods is used together with the main, medical or surgical, line of treatment.
An effective way to fight the disease is a mixture prepared on the basis of garlic and horseradish. To do this, mix 50 g of horseradish gruel and the same amount of garlic with 0.5 kg of honey and half a pack of butter. The product must be stored in the refrigerator. Take 1 time per day 50 g 10-15 minutes before meals.
There is another simple folk remedy: mix one raw chicken yolk with 1 teaspoon of lemon juice, beat with a fork until smooth. Take the mixture once a dayafter meals, preferably at night. Chicken yolk can be replaced with quail.
For another folk remedy, you will need 2 tbsp. l birch buds, insist them in 1 glass of alcohol and 1 liter of honey for 10 days. Be sure to take into account that the composition must be infused in a dark place. Take strictly before meals three times a day, 2 teaspoons.
Another recipe: mix 50 ml of aloe juice, 100 g of lard and 100 g of honey. Use a mixture of 1 tbsp. spoon after eating. Store in a dark place. Additionally, you can take at night with warm milk.
Crush dry comfrey root in a mortar and mix in equal proportions with pork fat. Apply the finished ointment, evenly distributing it on the affected areas as an analgesic several times a day. For a restful night's sleep, it is necessary to apply the composition in the evening, wrapping cling film on top.
In folk medicine, much attention is paid to nutrition in the treatment of bone tuberculosis. The right choice of products is considered one of the success factors in the fight against the disease. The patient's diet should contain a large amount of protein, both animal and vegetable. This is due to the fact that in tuberculosis there is a breakdown of protein in the tissues. Along with protein, it is necessary to regularly consume foods rich in carbohydrates, preferably cereals. Vitamins are needed, obtained from fresh products, and, if necessary, from vitamin complexes.
Therapeutic exercise
If with tuberculosis of the bones the areaIf the lesion is small and when carrying out procedures aimed at relieving inflammation, it was possible to defeat active inflammation of the bone tissues, then the doctor has the right to prescribe physiotherapy exercises to the patient. Physiotherapy exercises are mainly aimed at preventing the loss of muscle mass in the affected area, as well as stopping repeated bone deformities by strengthening the surrounding muscles.
A set of exercises is selected in such a way that the patient does not feel discomfort in the affected part of the body under such loads. At the same time, it is imperative to keep the whole body in good shape, which will speed up metabolic processes.
The general tone of the body can be raised by regular massage or a visit to the bath.
When conducting physiotherapy exercises, it is necessary to adjust the patient's diet. The diet requires the presence of dairy and other products rich in calcium, as well as foods rich in protein and vitamins. You can take vitamin complexes.
If after physical therapy the patient feels worse or the mobility of the joints has not improved, then the patient may be prescribed arthroscopy or total joint replacement.
