Tuberculosis of bones according to various experts ranging from 10% to 20% of extrapulmonary tuberculosis. This often tuberculosis affects the spine, hip, knee and ankle joints. The death rate from this disease is virtually absent, but the disability is present almost always lasts for years.
Causes of bone tuberculosis
Like other types of extrapulmonary tuberculosis
Extrapulmonary tuberculosis - many forms
Tuberculosis of bones and joints develops against the background of already existing tuberculosis soft tissue, usually on the background of pulmonary tuberculosis. Today it is known as bone tuberculosis is transmitted. The infection enters the bone-joint system through the blood and lymphatic system. And how often this occurs against the background of primary tuberculosis, which can go on their own without treatment, sometimes the primary source of infection in patients with bone tuberculosis can not be identified. Patients with tuberculosis of bones is not the source of infection, of course, if he does not open (with the release of tons of Mycobacterium tuberculosis from sputum) pulmonary tuberculosis.
TB infection affects most often the bones, which is a lot of spongy tissue (type of cellular bone beneath the solid compact bone and formed bony plates lying loosely under the spongy substance is bone marrow tissue). These are the bones of the vertebrae, and the joint sections of long bones. Most often tuberculosis affects the spine, hip, knee and ankle joints.
After contact with Mycobacterium tuberculosis in a bone, the bone marrow develop TB granulomas. Most of these granulomas further resolve, but under unfavorable conditions (supercooling, trauma, poor diet, low immunity) they grow and undergo caseous (cheesy) necrosis. Formed in their place pockets of tuberculosis (osteitis) covered capsules and can long remain isolated. Upon activation of the process it can spread to the bones or joints of the vertebrae, causing bone tuberculosis
Tuberculosis - a full recovery is not guaranteed
(spondylitis if the affected spine or arthritis
Arthritis - a variety of forms and complications
If the affected joint).
Symptoms of tuberculosis of bones
Current osteoarticular tuberculosis is usually a slow, long-term. Tuberculosis of bone is almost always leaves behind consequences in the form of various deformities of bones, abscesses, fistulas, and a variety of neurological disorders. But sometimes the process starts over expression (subacute), it is usually associated with the presence of mixed infections: tuberculosis in combination with a non-specific bacterial.
It starts tuberculosis of bones with general malaise, weakness, fatigue, loss of appetite, irritability, sleep disturbances, low-grade fever. May appear indeterminate nature of pain in the affected area, but more often in the initial stages of the disease they do not happen. Just occasionally there is a little swelling and soreness surrounding soft tissues.
When passing the disease to the next stage - the defeat of the joints there is a characteristic triad of symptoms: pain, organ dysfunction and atrophy (decrease in volume) of muscles involved in the movement of the joint. At the beginning of this phase, pain is uncertain, but gradually it is concentrated in the affected bone and joint mobility is accompanied by a violation of stiffness (rigidity) of muscles.
In the next phase there is an infringement of the articular surfaces of bones or vertebrae deformity that leads to permanent joint dysfunction. If it affects the joints of the lower limbs of the patient appears and gradually increases lameness.
Further signs of tuberculosis
Symptoms of tuberculosis - easily overlooked
bones are quite typical. When tuberculous arthritis appears a thickening of the skin fold on the affected side (a symptom of Alexandrov). In tuberculous spondylitis there is a "symptom of the reins": muscle tension coming from the blades to the affected vertebrae.
Then gradually increase the deformation of the skeleton affected areas: joints become characteristic spindle-shaped, spinal deformity manifests itself first "bellied" an emergence of the spinous process of the affected vertebra, which gradually turns into a pronounced kyphosis (hump). Simultaneously, the surrounding soft tissues can be formed tubercular abscesses.
The disease can occur in waves, then dying away, then it flared up again. If persistent remission process comes postartriticheskaya (postspondiliticheskaya) stage, which is characterized by a combination of residual tuberculous changes to bone deformities and dysfunction of affected organs. At this stage, often develop a neurological disorder resulting from compression of the spinal cord and its vessels.
Tuberculosis of bones in children occurs as well as in adults, imperceptibly. Parents often associated with the onset of the disease injury, but the injury in this case is only a starting point, which activates existing tubercular process in the spine or joints.
Diagnosis of tuberculosis of bones
The diagnosis is made by patient complaints, medical examination, positive tuberculin test, as well as the data of X-ray and laboratory examination.
Treatment of bone tuberculosis must be complex, comprising as conservative medical and surgical treatment.