Bone TB: The Hidden Threat Behind Back and Joint Pain

1. Bone Tuberculosis: Causes, Symptoms, Bone Tuberculosis: Causes, Symptoms, Diagnosis & Treatment Diagnosis & Treatment Tuberculosis (TB) is a disease that most people associate with the lungs. However, it’s important to know that TB can affect other parts of the body, including the bones and joints. This lesser-known form of TB is known as Bone Tuberculosis or Osteoarticular Tuberculosis. Although less common than pulmonary TB, bone TB can lead to serious complications if not diagnosed and treated early. In this blog, we’ll explore bone tuberculosis in detail—covering its causes, risk factors, symptoms, diagnosis methods, and treatment options. What is Bone Tuberculosis? What is Bone Tuberculosis? Bone Tuberculosis is a form of extrapulmonary tuberculosis where the Mycobacterium tuberculosis bacteria infect bones and joints instead of the lungs. It is a chronic and progressive infection that can affect the spine, hips, knees, or any other bone. In many cases, it starts silently and may not be diagnosed until significant damage has occurred. This condition accounts for nearly 10–15% of all extrapulmonary TB cases and is more common in developing countries due to late diagnosis and poor access to medical facilities. How Does Bone Tuberculosis Occur? How Does Bone Tuberculosis Occur?

2. Bone tuberculosis doesn’t usually start in the bones. The TB bacteria typically spread from an infected lung or lymph node through the bloodstream or lymphatic system. Once the bacteria settle in the bone, they begin to multiply and cause inflammation, leading to pain, swelling, and bone destruction over time. Spinal tuberculosis, also known as Pott’s disease, is the most common form of skeletal TB and can cause spinal deformities and neurological complications if untreated Risk Factors of Bone Tuberculosis Risk Factors of Bone Tuberculosis While bone TB can affect anyone, some people are more susceptible to the condition due to several risk factors: Weakened immune system (e.g., HIV/AIDS patients) Malnutrition Chronic diseases like diabetes History of tuberculosis infection Poor hygiene and living conditions Lack of vaccination (BCG) Substance abuse (alcoholism, smoking) Use of immunosuppressive drugs Older adults and children are more vulnerable Being aware of these risk factors can help with early detection and prevention. Common Sites Affected by Bone Tuberculosis Common Sites Affected by Bone Tuberculosis Bone tuberculosis can affect almost any bone or joint, but it is more commonly seen in: 1.Spine (pot’s disease ) 2.Hips 3.Knees 4.Shoulders 5.Wrists and Elbows 6.Sacroiliac Joints . Among these, spinal TB is the most dangerous as it may compress the spinal cord and lead to paralysis. Signs and Symptoms of Bone Tuberculosis Signs and Symptoms of Bone Tuberculosis

3. Bone TB progresses slowly. Its symptoms may be mistaken for other orthopedic issues, leading to delayed diagnosis. Some of the most common signs include: Persistent pain in the affected bone or joint Swelling or stiffness Reduced mobility Night sweats Fever, especially in the evenings Fatigue and weight loss Muscle spasms Cold abscesses (soft swellings filled with pus) In spinal TB, symptoms may also include: Back pain Curvature of the spine Weakness or numbness in legs Difficulty walking If you notice any of these symptoms, especially if you have a history of TB or a weak immune system, consult a doctor promptly. How is Bone Tuberculosis Diagnosed? How is Bone Tuberculosis Diagnosed? Bone tuberculosis is often difficult to diagnose because the symptoms are nonspecific and progress slowly. A thorough clinical examination along with a combination of imaging tests and laboratory investigations is required. Diagnostic tools include: Diagnostic tools include: X-rays– To look for bone lesions and deformities. MRI Scan– Useful to detect early spinal TB and soft tissue involvement. CT Scan– Gives detailed bone images for complex areas. Blood Tests– To check for elevated ESR and CRP levels (inflammation markers). Tuberculin Skin Test (Mantoux test)– Helps identify TB exposure. Interferon-Gamma Release Assays (IGRAs)– A blood test to detect latent TB. Biopsy and Culture– Tissue from the affected area is taken to confirm TB bacteria. GeneXpert/CBNAAT test– A molecular test to detect TB bacteria and drug resistance. Early diagnosis is crucial for preventing complications and starting the right treatment. Treatment Options for Bone Tuberc Treatment Options for Bone Tuberculosis ulosis

4. The good news is that bone TB is treatable and curable when caught early. The cornerstone of treatment is Anti-Tubercular Therapy (ATT) using a combination of drugs for an extended period. 1. 1. Medications (ATT Regimen) Medications (ATT Regimen) The standard TB treatment includes: 1.Intensive Phase (2 months): Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol 2.Continuation Phase (10 months): Isoniazid and Rifampicin. In total, 12–18 months of medication may be required depending on the site and severity of infection. Patients must follow the full course without interruption, even if symptoms subside early, to prevent recurrence or drug-resistant TB. 2. 2. Surgical Treatment Surgical Treatment Surgery may be necessary in the following cases: Severe spinal deformities Neurological complications Non-healing abscesses Bone destruction needing stabilization Surgical options include abscess drainage, debridement, bone grafting, or spinal stabilization with implants. 3. 3. Physiotherapy and Rehabilitation Physiotherapy and Rehabilitation After controlling the infe After controlling the infection, ction, physical therapy physical therapy helps in: helps in: Regaining joint mobility Preventing stiffness Building muscle strength Restoring full function A customized rehabilitation plan should be followed under medical guidance. What Happens if Bone TB is Left Untreated? What Happens if Bone TB is Left Untreated? Untreated bone tuberculosis can lead to severe complications, such as:

5. Permanent deformity Joint destruction Paralysis (in spinal TB) Chronic pain Loss of limb function Spread of TB to other organs Therefore, early medical attention and strict adherence to treatment are critical. Prevention of Bone Tuberculosis Prevention of Bone Tuberculosis Prevention of TB in any form relies on general public health measures and personal care. Here are some ways to reduce your risk: Get vaccinated with the BCG vaccine at birth Practice good hygiene and sanitation Ensure proper ventilation in living spaces Avoid contact with known TB patients Maintain a healthy diet to boost immunity Complete TB treatment fully if diagnosed Get regular health check-ups, especially if you’re in a high-risk group Livin Living with Bone Tuberculosis: What to Expect g with Bone Tuberculosis: What to Expect Recovery from bone TB may take several months. Most patients recover fully with proper treatment and lifestyle adjustments. However, it requires patience, discipline, and regular follow-ups with your doctor. Tips for coping: Take all medications as prescribed Attend follow-up appointments Maintain a positive mindset Follow a balanced diet rich in calcium and protein Avoid strenuous activity during the healing phase Get adequate rest and sleep When to See a Doctor? When to See a Doctor? Visit your doctor immediately if you have: Chronic pain in the back or joints

6. Unexplained weight loss and fatigue Night sweats and prolonged fever Swelling or deformity in the bones Early evaluation can make all the difference in preventing long-term damage. Conclusion Conclusion Bone tuberculosis may not be as well-known as lung TB, but it can be just as dangerous if left undiagnosed. Thanks to advances in diagnostics and treatment, complete recovery is possible with the right approach. Early detection, consistent medication, and supportive therapy are key to managing bone TB effectively. If you or someone you know is experiencing symptoms of bone TB, don’t delay. Seek medical attention at a trusted multispecialty hospital like Karpagam Hospital, where expert care meets compassionate service. For more information: https://karpagamhospital.in/bone-tuberculosis/