Bone Tuberculosis Symptoms: Causes, Diagnosis, and Treatment

India accounts for nearly 27% of the global TB cases, the highest TB burden in the world. 

Bone tuberculosis (TB) is a rare but serious form of TB that primarily affects bones and joints. It is caused by the Mycobacterium tuberculosis bacteria, which spreads beyond the lungs and affects the bones. If the disease is left untreated, this condition can lead to serious complications, pain, deformities, and disability.

The bacteria is transmitted through an infected person with the infection's cough, speaks, or sings. 

It commonly affects the spine, long bones, and joints, causing complications such as spinal deformities and damaged joints. It spreads to the bone and is also known as bone tuberculosis. However, early diagnosis and treatment can help to prevent long-term complications. 

Other names of bone TB are osteoarticular, musculoskeletal, and skeletal TB.

TB is preventable and treatable if treatment is started early. However, TB can be a fatal condition. Read more about bone TB and its causes, risk factors, and symptoms. 

What Causes Bone Tuberculosis?

• People with TB can transmit the bacteria through their breath. People are most likely to spread TB from infected people they spend time with in person, such as family, friends, or co-workers.
• People may catch TB bacteria by breathing. The bacteria are present in the air around the infected person, can grow, can be easily transmitted through the lungs or throat, and then spread to the bones. If the infection transmits to bones, it spreads to develop as bone TB.
• Research shows that bone TB alone cannot transmit the infection. A person with bone TB cannot transmit it to others. However, TB is transmissible if the bacteria are present in the lungs, throat, and bones. If a person comes in contact with pus, the infection can travel into your blood and transmit the disease.

However, the condition is often associated with:

• Weakened Immune System
• Malnutrition
• Close Contact with an Infected Person
• Unhygienic living conditions, like poor sanitation and overcrowded living conditions.

Who is at high risk of Bone Tuberculosis?

People with weak immunity have a higher chance of TB, including infants and people with the following conditions- 

• Type 2 diabetes
• Head and neck cancer
• Severe kidney disease
• HIV
• Silicosis (a lung disease caused by breathing in very small silicon particles) 
• Low body mass

Certain treatments may weaken immunity, such as:

• organ transplantation
• corticosteroids
• Certain medications like arthritis 

What Are the Symptoms of Bone Tuberculosis?

The symptoms of TB are often unnoticeable. Bone Tuberculosis is challenging to diagnose because symptoms don't appear until the infection is severe or advanced. The symptoms of Bone TB may include- 

• Severe back pain
• Inflammation in the back or joints
• Weight loss
• Fatigue and general weakness
• Chronic Pain
• Swelling and Tenderness
• Bone and Spinal Deformities
• Abscess Formation
• Paralysis
• ‌Neurological disorders
• ‌Tuberculosis-related meningitis
• ‌Muscle weakness 

If a person has TB or has been in close contact with people with TB, then they should get tested. People with TB may experience severe complications if they do not get sufficient treatment. 

How to Diagnose Bone Tuberculosis?

Consult your symptoms with your doctor, and based on your symptoms, medical history, and other clinical history, your doctor may recommend you bone TB tests-

Imaging Tests

• X-rays
• MRI (Magnetic Resonance Imaging)
• CT Scan

Laboratory Tests

• Tuberculin Skin Test (Mantoux Test): A positive test indicates TB exposure but does not confirm bone TB.
• Interferon-Gamma Release Assays (IGRA) and TB gold measure the immune response to TB bacteria.

Microbiological and Biopsy Tests

• Bone Biopsy: A small sample of affected bone tissue is taken to detect TB bacteria.
• Polymerase Chain Reaction (PCR) Test: The sample is collected from Tissue, Menstrual Blood Sample, Sputum, Urine, and Fluids and used to analyze the infection to find out the presence of bacteria

Also read: Blood Test for TB: Symptoms, Purpose, Procedure, and Results.

Treatment of Bone Tuberculosis

Without treatment, bone tuberculosis can be deadly. Here are some treatments to reverse the damage of bone tuberculosis:- 

• Anti-Tuberculosis Medication—The primary treatment for bone TB is a 6—to 9-month course of anti-TB drugs, such as Isoniazid (INH), Rifampicin (RIF), Ethambutol (EMB), and Pyrazinamide (PZA). In severe cases, the treatment may extend up to 12 months to ensure complete bacterial eradication.
• Corticosteroids- Your doctor may advise these medications to prevent complications like inflammation around your spinal cord or heart.‌
• Surgery (in Severe Cases)—If the condition is advanced and has complications, your doctor may recommend surgical treatment.

Your doctor may also advise you to eat a healthy diet rich in protein, essential minerals, vitamins, and calcium, which strengthens bones and aids recovery.

Also read: TB is preventable & Curable: Steps Individuals & Communities Can Seek to Reduce the Risk of Infection.

The Key Takeaways

Bone tuberculosis is serious but can be treated with early diagnosis and proper medical intervention. It can be transmitted through the droplets from an infected person's lungs and throat. Bone TB symptoms often develop slowly, and it is very challenging to diagnose. 

Doctors may advise antibiotics, chemotherapy, and surgery to treat TB. However, a person undergoing bone tuberculosis treatment must take precautions and follow the treatment plan actively. 

Complete the entire course of antibiotics as your doctor prescribes, get enough nutrition to support the healing process, and attend physical therapy sessions regularly. With proper medical care, patients with bone TB can recover fully and lead healthy lives.

Worried about bone TB? You can get yourself tested with Redcliffe Labs. Here, professionals will provide free guidance to help you understand the condition. Book your TB test today and make your diagnostic journey smooth and hassle-free.

FAQ’s

1. How Much Does a Bone TB Test Cost?

The price of a TB test may vary from lab to lab. However, it may range between 1500 and 2000 rupees.

2. How Serious is Bone TB?

Bone tuberculosis (TB) is a rare and serious condition that can lead to significant complications like deformities, joint destruction, and neurological issues if left untreated. 

3. How Long Does a Bone TB Take to Recover?

The recovery from bone tuberculosis may take 6 to 18 months with medication and proper treatment. 

4. Is Bone TB Completely Curable?

Yes, bone tuberculosis (TB) is curable with appropriate and timely treatment. Follow your doctor's treatment plan. 

5. Is Bone TB Contagious?

Bone tuberculosis (TB is not directly contagious like lung TB, but the underlying Mycobacterium tuberculosis bacteria can spread through respiratory droplets if the patient also has active pulmonary TB. 

6. What blood tests detect bone TB?

The blood tests for bone TB are Interferon-Gamma Release Assays (IGRAs) and tests for markers of inflammation, such as CRP and ESR tests. 

7. What are the early signs of TB's spine?

Some early signs of TB spine include back pain, spinal tenderness, paraplegia, and spinal deformities.