Tuberculosis of bones and joints
Note: if the second phase of tuberculosis of bones and joints is accompanied by the formation of a fistula, then this can be a dangerous condition for the patient - the attachment of a secondary infection occurs in almost every case of .
The phase of attenuation occurs only if the patient was diagnosed in time and effectively treated. There are often residual deformations of the joints and bones, but it is possible to completely restore the normal functioning of the osseous parts.
In order to diagnose "tuberculosis of bones", the doctor conducts clinical, laboratory and radiographic studies.
At the initial visit to the doctor, the patient is obligated to provide answers to such specialist questions:
- was there any contact with a patient with tuberculosis;
- what are the results of the Mantoux test;
- what infectious diseases the patient has had during the last 12 months;
- at what time the general symptomatology appeared;
- are there any signs of intoxication.
At visual inspection of the patient, the doctor should appreciate the position of the affected skeleton, its contours and volumes, the density of the joint bag, the color of the skin in the place of pathological lesion.It also reveals the general and local body temperatures, pain points and the level of muscle tone.The sick limb must be compared with the healthy one, which will help the doctor determine the degree of change in its length, the presence / absence of muscle atrophy.
X-ray examination of
The earliest sign of bone tuberculosis in the X-ray image is osteoporosis of the bones, which occurs due to intensive resorption of lime and bone septa itself.Moreover, osteoporosis in this disease is determined not only in the place of bone damage, but also along its entire length.
An X-ray taken as part of the diagnosis of the disease in question will help the specialist determine:
- narrowing of the joint slits;
- stratification of intermuscular spaces;
- uneven cartilage surfaces;
- blurred outlines of damaged bones;
- tuberculous abscess.
If the patient is systematically monitored for the dynamics of the disease, then in the active phase of its development the following changes will be noted:
- increase in the lesion;
- narrowing and disappearance of intervertebral and interarticular cracks;
- destruction of the trabecular network;
- formation in the bone cavities with small impregnations;
- an extension of the pathological process to the neighboring departments of the human musculoskeletal system.
In principle, when diagnosing tuberculosis of bones and joints, doctors apply a standard set of laboratory tests - the patient is taken for blood analysis, punctured and given the biomaterial from the bone marrow for histological examination, computed tomography and myelography.
Note: diagnostic measures for suspected tuberculosis of bone are also needed to differentiate the considered disease from dystrophic and nonspecific lesions of joints and bones( for example, arthrosis, rheumatism) and malignant tumors.
Basic principles of the treatment of tuberculosis of bones and joints
Treatment of the disease in question is characterized by a duration of at least one and a half years, and can reach a three-year period. Only phthisiatrician can prescribe effective treatment, because this is done taking into account the development phase of tuberculosis of bones and joints, the condition of internal organs, the body's reaction to infection and many other factors.
To treat tuberculosis of bones and joints was really effective, the patient should undergo complex therapy.
Local orthopedic treatment
It consists in unloading and immobilization( ensuring immobility) of the affected organs.If the patient is diagnosed with tuberculosis of the hip joint or spine, then it must be placed on a plaster bed.The patient in this gypsum "cocoon" remains throughout the active phase of the disease in question.Throughout this period, doctors should monitor the correct position of the pelvis and lower limbs.
Once the disease in question has entered the phase of decay, the doctor will recommend the patient to wear a corset or special removable orthopedic devices.However, the latest recommendations will be appropriate only if there are deformations of bones and joints.
It will be most effective in the first phase of tuberculosis of bones and joints - specially selected medications will stop the spread of the disease and will prevent the development of complications.For this purpose, doctors use Kanamycin, Cycloserine, Streptomycin, Rifampicin and Viomycin.
If chemotherapy drugs are used in the treatment( Ftivazid, Megiazid and others), in 95% of cases the tuberculous process in bones and joints stops, the patient fully recovers.
Note: in some cases, doctors prescribe hormonal drugs to their patients, which are intended to improve the overall condition of the patient with tuberculosis of bones and joints.Such hormonal therapy requires constant clinical observation and regular blood and urine tests.
Doctors choose this method of treatment of bones and joints tuberculosis very rarely - for example, in case of ineffectiveness of therapeutic treatment, or when it is impossible to take specific medications( for example, it can be contraindicated for such drugs).
An important part of the complex therapy against tuberculosis of bones and joints is therapeutic gymnastics.If the patient has an active phase of the disease in question, the goal of therapeutic gymnastics will be prevention of muscular atrophies, prevention of secondary deformations and improvement of overall well-being.
Note: during the therapeutic gymnastics in the active phase of the disease in question, the part of the body that is "packaged" in the gypsum should remain stationary.
With the extinction of the pathological process, therapeutic exercises become more active, the specialist can also conduct several massage courses - all together will have a beneficial effect on the recovery of the body.
Tuberculosis of bones and joints is an unpleasant, but absolutely non-fatal disease.Modern medicine can perfectly treat it, so everything depends only on the patient himself - at the first signs of the disease in question one should apply for qualified medical care and fulfill all the prescriptions of doctors.
Tsygankova Yana Aleksandrovna, medical reviewer, therapist of the highest qualification category