Some Facts Worth Knowing About Bone TB
We most often think of tuberculosis as a disease of the lungs, which it almost always is, but bone TB, although not quite as common, also takes its toll on a percentage of those who initially have had a lung infection. The reason we tend to associate tuberculosis with the lungs is that it is in the lungs where the infection almost always initially takes place. Tuberculosis is a highly contagious disease. It is spread from one person to the next by very tiny droplets that are expelled from the mouth when someone who has been infected with the disease coughs or sneezes.
Only a few of these tiny droplets need to be inhaled to become infected, which is one reason why tuberculosis infections have in times past reached epidemic proportions. Tuberculosis is a serious issue in a number of countries in the world, though not so much at the present time in Western Europe or North America. Aside from the Native American population in Alaska, fewer and fewer cases of the disease have cropped up in the United States during the decades following the 1940's.
Any Part Of The Body Can Be Affected - The tuberculosis bacteria can affect any tissue in the body, but almost always initially takes hold in the lungs. In roughly 90% of all cases, TB will remain confined to the lungs, but tissue damage can allow the bacteria to enter into the bloodstream and spread to other parts of the body. When TB is confined to the lungs it is called pulmonary tuberculosis. It is spreads beyond the lungs, it is called extrapulmonary tuberculosis. If the infection does spread beyond the lungs, it is most apt to spread to the central nervous system (tuberculosis meningitis), the genitourinary system, the lymphatic system, or into the bones and joints. Bone TB is referred to in medical terms as osseous tuberculosis. The intestinal tract and skin can sometimes also become infected. The heart and skeletal muscles can become infected as well, but such instances are quite rare.
Not All Infections Become Active - As we have seen, tuberculosis bacteria can be spread relatively easily, yet when there is an outbreak of the disease it is usually not as widespread as one might have reason to fear. Thus is because roughly 9 out of 10 who are exposed and become infected have what is termed a latent tuberculosis infection, where the tuberculosis bacteria are present, but never become active. Those who have the latent form of tuberculosis will test positive for the disease, but they will not exhibit any symptoms of the disease, nor will they suffer any ill effects, at least not initially. Between 5% and 10% of those who have a latent infection might at some point in their lives experience an active form of the infection.
When Bone Tuberculosis Strikes - Bone TB occurs in roughly a third of the cases where there is an extrapulmonary infection, in other words, when the infection has spread beyond the lungs. The spine is most often affected, and can become weakened to the point of collapse if the disease is left untreated. Tuberculosis of the spine is called Pott's disease. When long bones in the body become infected, abscesses may form if the infection spreads to soft tissues. The abscesses can extend into the joints, and as a result the joints may become permanently damaged.
Early Warning Symptoms - A person who has a tuberculosis infection will usually begin to feel symptoms before the infection can spread to the bones or to other parts of the body. These symptoms generally include a low-grade but persistent fever, fatigue, night chills, and occasional weight loss. As the disease progresses, the infected person will begin to spit up sputum and perhaps blood as well. When these symptoms occur the infection is well-established in the lungs, but may not yet be present or well-established in other parts of the body.
Tuberculosis Treatment - Many years ago the primary method of treating tuberculosis, including bone TB, was fresh air coupled with extended bed rest. At times surgery would also be required. Bed rest is still recommended, but today there are medicines, such as streptomycin, which are very effective in combating the tuberculosis bacteria. Thus, when the disease is treated early on, the prognosis is usually quite positive. Tuberculosis symptoms can often be very slow to develop, but insofar as bone tuberculosis is concerned the symptoms are usually present before the infection has a chance to take hold. Bone tuberculosis no longer has the devastating impact on people it once had, at least in areas where treatment for the disease is readily available.
Once treatment (using medications) begins, it usually continues for at least 6 months, although in some cases it may take a person a year or two to recover completely. A person who does not have to be confined to a bed during this time will still need to take it easy, and in many cases will feel like doing just that. Depending upon the severity and location of the infection, bone TB symptoms can range from a mild pain at one extreme to joint immobility at the other.