Bone Tuberculosis

Bone Tuberculosis - Difficult To Detect, Normally Easy To Cure

Bone tuberculosis can be one of the more difficult diseases to detect. Symptoms are not always present, or at least noticeable in the early stages of the disease, and when symptoms do make themselves known, they often appear to be symptoms of a completely unrelated disorder. We generally associate tuberculosis with the lungs, and most cases of the disease are centered in the lungs. Tuberculosis is contagious, and in many parts of the world is still considered a dread disease. Although deaths due to tuberculosis are some what rare in this country today, such was not always the case, and as late as the mid-20th century the only known treatment was rest and occasional surgery to remove damaged portions of the lungs. It wasn't until the 1940's that medicines became available that could cure the disease.

The Cause - Tuberculosis is caused by M. tuberculosis, the tubercle bacillus, and is usually spread through the air. Once the bacilli are inhaled, they can settle in the lungs, where they are most often apt to cause a problem, and also enter the bloodstream, affecting other organs, and the bones. Bone tuberculosis is not as common as pulmonary tuberculosis, tuberculosis of the lungs, but about one in every five cases of tuberculosis affects the bones. Insofar as bone tuberculosis is concerned, it is usually the ends of the long bones and the bones in the spinal column that become infected.

Diagnosis Can Be Difficult - The presence of tubercle bacilli in the body does not always mean that a person has tuberculosis. In fact, most people who have become infected with the bacilli never come down with tuberculosis as the immune system comes into play and effectively suppresses the disease before it can gain a foothold. The bacilli are not necessarily destroyed, but become dormant, and may or may not cause a problem in the future. If tuberculosis has become established in the lungs, there are a number of symptoms arising which point to the presence of the condition. If one or more bones are affected however, symptoms may not be easily detected, at least not until the disease has become somewhat advanced. If presence of tuberculosis is suspected, there are several tests, including a skin test, which can confirm the presence of the tubercle bacilli. In the case of a spinal column infection, testing of a sample of the spinal fluid can usually confirm the presence of bone tuberculosis. Samples of bone marrow can also be tested for the disease.

Pain sometimes is symptomatic of bone tuberculosis, especially if the spine in involved. Any bone in the body can be affected, and in many instances, depending upon which bone is affected, detection can be very difficult. On occasion a number of bones may be affected, although this condition, called multifocal bone tuberculosis, is really quite rare.

Treatment Through Medication - Once detected, bone tuberculosis is usually quite treatable and most patients will completely recover. Relapses can occur, but are not considered common. Treatment is done through medication and is usually done in several stages. The first medication applied is designed to target the bacilli and lower the number as much as possible. Different medications are also given to prevent the bacilli from developing a resistance to medication. Two and sometimes three, different medications may be used to accomplish this. Still more medications are given over a longer period of time and are designed to prevent a recurrence of the disease.

Fortunately, for all types of tuberculosis, not just bone tuberculosis, the days are past when treatment consisted only of bed rest, fresh air, and a hope and a prayer. Modern drugs, starting with streptomycin, have indeed proven to be wonder drugs in fighting this disease.