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While those of us who thought TB is a
pulmonary disease affecting our lungs need to think again! According to
the medical statistics, 5-10 per cent of the total TB patients
in India suffer from bone TB and the
figure is on constant rise, more due to ignorance about bone TB, during which
the bacterium causing TB affects
bones and the spine. In fact, if
we talk about numbers, India is home to about one lakh people who suffer from
osteoarticular tuberculosis which leads to limb shortening in growing children
and full body paralysis in a few cases.
Although TB, primarily affects the lungs, it can spread
through the blood stream to other sites, commonly called extrapulmonary or
disseminated tuberculosis. Usually the ends of long bones and the vertebrae are
common sites of extrapulmonary tuberculosis and the disease can hit people
of every strata, no matter whether they are rich or poor.
Also, it can affect any bone, but most commonly
it attacks the spine and
weight-bearing joints, like hands, wrists and elbows. The type of pain too
depends on the exact location of the tuberculosis, for instance in case
of spine TB the pain in
lower back is so severe that the patient ends up seeking medical
treatment.
How to diagnose
spinal TB properly?
Bone TB in its early stages is often misdiagnosed
as arthritis. Therefore, to distinguish it from arthritic pain, patients should
observe the nature of pain. Most patients of arthritis experience relief at
night when lying down. Whereas for those suffering from bone TB, lying flat
increases discomfort due to increased bacterial activity.
Diagnosis of the disease is made by X-ray and
lab tests on fluid aspirated from the affected joint area. While in case
of spine and
skeletal TB, diagnosis are
to be done with the help of CT Scans and MRI reports.
Spinal tuberculosis, also called
"Pott's" disease, usually affects the thoracic part of the spine. It causes
constant and unbearable back pain as the virus degrades the discs cushioning
the vertebrae. TB in the
joints also causes an aching pain along with stiffness. While Tuberculous
osteomyelitis, or bone infection, causes constant pain in the bone itself and
can cause complications in nearby tissues, such as "carpal tunnel
syndrome" if the wrist is affected.
When a person is affected, tuberculosis of the
joints, progressively destroys the joints at the hips or knees. Doctors refer
to the condition as "mono-arthritis" because only one joint is
affected. The affected joint swells and becomes painful. With the result there
is stiffness in movement and range of motion is limited. In severe and chronic
cases, abscesses develop in the affected joints.
What are the
complications if left untreated?
Similarly, spinal tuberculosis, if left untreated, can
spread from one vertebra to the next, weakening the bones and destroying the
cushioning discs between them. In severe cases, the spine can
collapse and compress the spinal
cord, causing
paralysis of the lower body. And if spinal TB progresses to destruction of the
vertebrae and discs, the bones of the spine jut forward and form a hump. Spinal TB is severe
because if not detected and treated in time, the disease can cause severe
paralysis which may take years to get cured.
How to identify
the correct symptoms?
Patients with TB in their
bones might or might not exhibit generalized signs of tuberculosis such as
fever, fatigue, night sweats and unexplained weight loss. Although about half
of all patients with bone TB also have
infected lungs, the disease usually is not active there which also means that
most patients with bone TB do not
suffer from coughing and probably do not suspect that they have tuberculosis. At
times it may take years to start showing its initial symptoms.
Also, patients with bone TB are
generally not contagious because the disease spreads through coughed up active
virus particles unless you come in contact with a patient's pus. Another important
point to remember is that bone TB may affect the bone marrow, so timely and
complete course of treatment can only cure the patients. Duration of treatment
will depend on the location and severity of the infection. But unlike TB of lungs,
Bone and Spine TB takes a
little longer depending on the severity of infection.
Spinal TB is
curable
The treatment for normal bone TB may last
at least one year and in case of Spine TB causing paralysis treatment and recovery
time depends if paralysis is mild, moderate or severe. Also, in case of
MDR TB, in which
patients' fail to respond well to multi drugs, it may take longer to recover
completely. The TB patients'
are "strictly" advised to complete the medication course and never to
leave it in between, without consulting their doctor. It's important for
patients to understand that TB is curable if it is timely detected and
treated well. In case of Bone TB, bed rest, good diet, medicines and
physiotherapy can help you get back to normal life. Therefore, don't ignore
symptoms or take them lightly. Always remember, while TB usually
affects the lungs, it can also infect other parts of the body including
the spine, brain and
kidney. If proper medical attention is not received, TB can be
fatal.
