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.

Galina Romanenko

Chondroxide - this drug has a positive effect on metabolic processes in cartilage. He stops the aging and degradation of cartilage, stimulates recovery and release of synovial fluid. Furthermore, it has analgesic and anti-inflammatory effects, helps to increase the mobility of the modified joints.

The mechanism of action Chondroxide

Chondroxide (Active ingredient - chondroitin sulfate) - a drug for the treatment of diseases of the joints and spine, which is produced by domestic pharmaceutical Nizhpharm tablets in the form of gel and cream.

The mechanism of action is associated with the recovery Chondroxide metabolism Metabolism: The basis of life of all living things   in cartilage. Violations of metabolic processes in the degenerative diseases of the joints begins with its depletion chondroitin, which is a polysaccharide of animal tissue. This reduces the flexibility and strength of cartilage, its reduction in volume. This process is called cartilage degradation.

Active ingredient Chondroxide - chondroitin sulfate proteoglycan is the main component, which together with the collagen fibers are the basis of cartilage tissue. It is able to replace an endogenous (produced by the body) and chondroitin promote active restoration of cartilage tissue that stops the development of degenerative diseases of joints and spine, helps to restore cartilage and intervertebral discs, as well as the normal volume interarticular liquid. Chondroitin sulfate also decreases the activity of the enzymes that cause the destruction of cartilage, inhibits the release of biologically active substances that cause inflammation, has a light anesthetic effect.

As a result, with prolonged exchange application Chondroxide partially restored state articular cartilage, joint capsule, decrease inflammation and pain.

Additionally composed hondroksid as auxiliary substances include dimethyl sulfoxide, which has an additional analgesic, antiinflammatory and easy antibacterial action, prevents the deposition of fibrin in the joints of the protein, which is then formed connective tissue that disrupts the joint. Dimethyl sulfoxide also improves the penetration of active principle of the drug in the tissue of the joints.

Application hondroksid reducing the dose of anti-inflammatory and analgesic drugs, for example nonsteroidal antiinflammatory drugs (NSAIDs), which have many side effects.

Indications and contraindications

Apply hondroksid for the treatment of degenerative and inflammatory diseases of the joints (osteoarthritis) and spine (osteochondrosis).

In addition, hondroksid can be applied at any diseases of the joints, as well as degenerative and inflammatory diseases of periodontal tissues (periodontal) - Periodontal disease and periodontitis. It is used for faster recovery after injuries of joints and fractures. External dosage form (gel and ointment) is applied at the surface hemorrhages (hematomas), bruises and sprains.

Hondroksid contraindicated in case of hypersensitivity to the drug. It is also not applied to broken skin and mucous membranes. The use of tablets Chondroxide also contraindicated during pregnancy and nursing Breastfeeding - a personal choice   breast, and dosage forms for topical use prescribed for such patients, as well as children with caution.

How to apply

Hodroksid tablets (one tablet contained 0, 25 g of active principle) are used by a physician. They are appointed to two tablets twice a day, taken with or without food, with a little water. The course of treatment lasting at least six months, while after you stop taking the tablets of their effect is maintained for a few more months (depending on the stage of the disease). Repeated courses of treatment prescribed by the doctor individually indicated.

External Chondroxide dosage forms (ointment and gel) refer to drugs without prescription, but it is better to use prescribed by a doctor. Ointment or gel applied to the skin in the affected joint or spine, two - three times a day and rub until the drug is completely absorbed. Treatments - two or three weeks, the gel can be used for a longer time, up to three months. If necessary, repeat the treatment.

Side effects

Chondroxide may cause allergic reactions Allergic reactions: how to understand why you tickle in the throat . Tablets hondroksid oral sometimes cause nausea Nausea - there may be problems with the nervous system   and loose stools.

Chondroxide enhances the analgesic and anti-inflammatory effects of NSAIDS but also increases the effect of drugs which reduce the rolling capacity of the blood.

Galina Romanenko