Tuberculosis is a disease caused by the bacteria Mycobacterium tuberculosis. Although this disease most commonly infects the pulmonary system (the lungs), about 10 to 20 percent of all diagnosed cases of tuberculosis infect the bones. Bone tuberculosis can occur at any age and can infect any bone within the body. Symptoms of bone tuberculosis are often vague,making diagnosis difficult.
Tuberculosis is a disease that has been around since early Egyptian times. This disease is a bacterial infection that can be spread through the air when an infected person coughs or sneezes. In some countries tuberculosis is endemic, meaning it is an always present danger. In the United States, however, the disease is not as common but is still a threat, especially in larger cities.
The most common symptom is localized pain, often in the back because the spine is the bone often affected. Other symptoms may include fever and loss of weight. A cold abscess, which is swelling without inflammation, is often suggestive of bone tuberculosis. Because some of these symptoms are not specific to only bone tuberculosis, diagnosis is often difficult.
Disseminated Bone Tuberculosis
Disseminated bone tuberculosis, also known as multifocal bone tuberculosis, is very rare, accounting for less than five percent of all cases of bone tuberculosis. The infection of more than one bone is most common in patients who are immunocompromised (their immune system is compromised due to another disease or medical condition). The symptoms for multifocal bone tuberculosis are the same except that the pain may be present in several areas.
Radiographs such as X-rays and bone scans do not show any specific features that conclusively differentiate the disease as bone tuberculosis. Some common radiographic findings that suggest bone tuberculosis are soft tissue swelling, narrowing of joint space, cysts in the bone, and loss of disc height in the spine. Once bone tuberculosis is suspected based on the symptoms and scan findings, a biopsy of the bone in question can provide a differential diagnosis.
All types of tuberculosis are treated with antituberculous drugs. Three medications are given in combination to fight this disease, including isoniazid, rifampin and ethambutol. Because the tuberculosis bacteria can become drug-resistant, The Centers for Disease Control provide recommendations for the United States on the exact combination, dosages and duration of treatment based on the current trends.