Tuberculosis of bones and joints: localization and forms of the disease, ways of infection and symptoms, diagnostic technique, treatment of bone tuberculosis and joints

In this article, we will consider how to identify and treat bone-articular tuberculosis.

Content

Bone-articular tuberculosis - A severe infectious disease excited by a stick of Koch, which enters the spongy bone substance and contributes to its active destruction.

Localization and forms of bone-articular tuberculosis

The most frequent localization of the disease is the lungs, and bone tuberculosis is 20 % of the excess forms and is the second most frequency of manifestation.

The consequence of the infection is the rapid destruction of bone tissues, leading to dysfunction and a violation of the anatomical structure of the affected skeleton sections.

Thanks to innovative methods of therapy and vaccination, fatal cases from this disease are extremely rare. In half the cases, the disease can provoke disability and temporary disability. The consequences depend mainly on the timeliness of the diagnosis, the correct treatment and complexity of the form. According to the last ailment, it is divided into : osteomyelitis, osteoarthritis, tendovaginitis.
In 40 % of cases, an infection in the form of spondylitis, damage to the spine, which leads to its curvature, hunchbateness, and paralysis of the arms and legs, is manifested.

In 20% of cases, the stick affects the hip joints. Coxite provokes deformations and pathological dislocation of these joints. A disease of the knees is manifested at least - drives.

Cases of damage to other joints are diagnosed much less often. The result of the ankle tuberculosis is fusion and immobility. This disease rarely affects the wrists, the damage to both limbs and the attachment of gonitis and deer, damage to the elbow joint are characteristic of it. The rarest localization is pipe bones. It happens up to three years of age.

Ways of infection and symptoms of tuberculosis of bones and joints

Ways of falling wand are airborne, along with food or through unbearable hands. The infection is distributed by circulating blood and lymph. Cases of secondary infection are diagnosed when infection from the lungs to other organs and systems.

But, it is not necessarily when an infection gets a person gets sick. The self -destruction of bacteria in the case of a strong immune system may occur. The disease develops with weak immunity in combination with other negative factors.

The first phase— osteitis, characterized by rather weakly exposed symptoms. There is an organization of tuberculosis granulum, the number of which is growing gradually. The infected feels the severity in the ridge, tolerant pain in the joints and back, studying after relaxation. In a child, everything can proceed a little more complicated, with the presence of heat, impaired sleep and appetite, lethargy and irritability. This stage can continue in different ways, from a week to months.
The next phase is osteoarthritis - These are enhanced pains in the area in bones and joints, resembling radiculitis or neuralgic diseases. The synovial shells are affected. Movements become limited against the background of stiffness of joints and loss of elasticity of the spinal muscles. Manifestations of intoxication are possible, especially in babies. The patient has a gait. In the field of damage, swelling occurs, muscle cramps, the soft tissues atrophy, the temperature rises, the fold on the skin thickens. With the abscess, the skin is inflamed, a fistula with purulent discharge occurs, the risk of joining other infectious processes is born.
The third stage is Tendovaginite - attenuation of inflammation, general improvement, residual changes. The timely start of diagnosis and therapy can completely restore the function.

Diagnostic methodology K. complete tuberculosis

Diagnosis is based on the results of a comprehensive examination, including an anamnesis, inspection, x -ray, laboratory tests.

First of all, the doctor conducts an examination and draws up an anamnesis, finding out a number of facts:

the presence of recent communication with an infected person
positive Mantoux reaction
previous infectious diseases
the time of manifestation of the first signs
dysfunction of the affected bones
manifestation of intoxication

In the x -ray, tuberculosis of bones manifests itself in the form of osteoporosis. The picture reflects all phases, but they are somewhat belated in comparison with clinical manifestations.

Laboratory methods for this localization do not differ from those that are used for other types of tuberculosis. A dubious diagnosis is refuted by negative tuberculin tests.
An important and informative is cytological analysis. But diagnosis is carried out exclusively during the period of diffuse process.
To diagnose the phase of the disease, MRI, CT, Myelography are used. Progressive Ostith requires the delivery of laboratory tests for ESR, leukocytes.

In the event of non -specific lesions, dystrophy of joints and bones, the tumors are carried out differential diagnosis.

Treatment of bone tuberculosis and joints

Treatment is a long process, which requires from one and a half to three years of time. At the same time, treatment undergoes comprehensively, and methods are prescribed taking into account the complexity of the disease, the body's reaction to the stick, the degree of damage to organs and systems. Two main tasks of treatment are increasing immunity and destruction of infection.

In order for the treatment to be successful, the patient needs comfort, full nutrition, lack of stress and fresh air. For this, sanatorium conditions are best suited.
An important method is the local orthopedic treatment aimed at unloading and immobilization of the affected organ, for which a gypsum bed is applied for the entire time of the active phase. At the attenuation stage, gypsum is replaced by corsets and removable orthopedic devices.
The treatment complex includes antibacterial therapy, which prevents the reproduction of pathogenic microorganisms.
Also fading the process promotes chemotherapy. The use of these methods allows ninety -five percent of cases to stop the disease and achieve a complete cure.
To generally improve the condition of the body, hormonal therapy is prescribed.

If conservative treatment does not give the proper result, surgical methods are used that reduce the duration of treatment and eliminate pathological processes in the bones. The surgical method helps effectively restore motor functions.

An integral part of complex therapy is therapeutic gymnastics that prevents muscle atrophy and secondary deformations. In addition to exercises, massage is prescribed, saline-chip baths.