Skeletal Tuberculosis: Understanding Its Impact on Bones and Joints - Dr Ravikumar T V

Tuberculosis (TB), historically known as the “White Plague,” remains one of the most lethal infectious diseases worldwide, surpassing malaria and even HIV/AIDS in mortality rates.

While TB primarily affects the lungs, it can spread to other parts of the body, leading to a condition known as extrapulmonary tuberculosis (EPTB). One such form is skeletal tuberculosis, which targets the bones, spine, and joints, often causing debilitating complications.

How Tuberculosis Spreads

TB is caused by Mycobacterium tuberculosis, a bacterium that spreads through airborne droplets when an infected individual coughs or sneezes. While one-third of the global population is estimated to carry the bacteria, only 5-10% develop active TB during their lifetime.

The body’s immune response often contains the infection, but individuals with weakened immunity—due to malnutrition, HIV, diabetes, or pregnancy—are at higher risk of progression to active disease.

Understanding Skeletal Tuberculosis

Skeletal tuberculosis occurs when TB bacteria travel from the lungs or lymph nodes through the bloodstream, eventually infecting the spine, long bones, and joints.

This condition is particularly dangerous as it can lead to chronic pain, structural deformities, and mobility issues if not diagnosed and treated in time.

Symptoms of Skeletal Tuberculosis

The symptoms of skeletal TB often develop gradually, making early detection challenging. Common indicators include:

• Systemic symptoms: Fever, night sweats, unexplained weight loss

• Bone and joint symptoms: Persistent back pain, joint stiffness, swelling, tenderness, muscle weakness, and restricted movement

• Severe complications: Spinal deformities, abscess formation, and in extreme cases, paralysis

Diagnosis and Medical Evaluation

Early and accurate diagnosis is crucial for effective treatment. Physicians rely on:

• Clinical evaluation: Assessing symptoms and medical history

• Imaging studies: X-rays, CT scans, and MRIs to detect bone damage

• Laboratory tests: Blood tests and, in some cases, tissue biopsies to confirm TB infection

Treatment and Management

Treatment for skeletal tuberculosis is long-term and multi-faceted, often lasting 12 to 18 months. The approach includes:

1. Anti-tubercular Therapy (ATT): A combination of four first-line TB drugs, gradually tapered over time.

2. Supportive Care: High-protein, nutrient-rich diet, rest, and pain management with analgesics.

3. Rehabilitation: Gradual mobilization through physiotherapy to restore strength and function.

4. Surgical Intervention: In severe cases, procedures may be required to drain abscesses, remove damaged bone, or stabilize the spine and joints.

Recovery and Prognosis

Although skeletal tuberculosis is a serious condition, early diagnosis and appropriate treatment significantly improve outcomes.

However, delayed intervention can lead to permanent disability or life-threatening complications. Patients must adhere to their prescribed medication regimen and follow medical guidance for a full recovery.

Conclusion

Skeletal tuberculosis, though less common than pulmonary TB, is a significant health concern that can severely impact quality of life. Raising awareness about its symptoms, timely diagnosis, and comprehensive treatment is crucial in combating this disease.

If you or someone you know experiences persistent bone or joint pain along with systemic TB symptoms, seeking medical attention promptly is essential.