World TB Day 2024: Understanding The Complications Of Bone Tuberculosis

Tuberculosis is a disease that usually affects your lungs, but when it spreads to the bones, it is known as bone tuberculosis or osteoarticular tuberculosis. It is a rare but serious disease that can lead to deformities and disability if left untreated. According to the WHO, over 1.5 million people died from tuberculosis in 2020, and there's been a constant rise in numbers since then. This serious illness is also the 13th leading cause of death worldwide.

Bone tuberculosis occurs primarily from infection with Mycobacterium tuberculosis bacteria. Unlike pulmonary tuberculosis, this particular type of TB does not directly spread through the air; rather, these bacteria typically enter the body through the lungs and can then travel through the bloodstream, affecting the spine, bones, and joints.

It begins with problems like mild joint pain, mild joint swelling, evening rise of temperature, weight loss, making it more complicated to understand and diagnose. Once a patient has been affected by TB of the bones, there are some signs that one should watch out for:

• Persistent Pain: TB of the Bone often starts with chronic pain in the affected bone or joint that doesn't go away.
• Swelling and stiffness: The area around the joint may become swollen and stiff, making movement difficult.
• Weight Loss: One might experience sudden, unexplained weight loss without controlling the diet or putting in any other effort.
• Fatigue: Feeling tired all the time can be a sign that should not be ignored.
• Night Sweats: With irregular sleep, waking up in a sweat at night consistently for the past two to three weeks can be a sign of TB of the bones.

When TB of the bones is in a more advanced stage, symptoms like neurological complications, persistent inflammation in joints, kyphosis, paralysis, limb-shortening in children, and bone deformities can be seen.

Early recognition of the disease and its diagnosis is of utmost importance, and if left untreated, TB of the bones can cause severe damage to the bones as well as to the adjoining joints, resulting in chronic pain that can lead to disability if not addressed early.

Preventive measures such as certain lifestyle modification, eating fresh food, and avoiding alcohol and tobacco can make a difference. Anti-tubercular drugs are suggested in the initial stages to treat it with medications, but in severe cases, surgery is done to remove an infected part. For effective treatment, DOTS (Direct Observed Treatment Therapy) is recommended for management of tuberculosis.

(Dr. Rajeev Verma, Head- Department of Joint Replacement and Orthopaedics at Manipal Hospitals, Dwarka)

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