Musculoskeletal Tuberculosis: Causes, Symptoms, Diagnosis, and Treatment

What Are the Types of Tuberculosis?

The most common contagious disease, tuberculosis, can be a deadly disease. It is prevented by giving Bacille Calmette-Guerin vaccine or BCG vaccine at the birth of the child. The major two types of tuberculosis are

• Pulmonary Tuberculosis - The condition that mainly affects only the lungs. It can cause lung problems, chest pain, and trouble breathing.

• Extrapulmonary Tuberculosis - The condition that spreads tuberculosis to all areas of the body, from the lungs. It is more common in immunocompromised patients. Extrapulmonary tuberculosis that affects the joints, bones, spine and other parts of the musculoskeletal system is called musculoskeletal tuberculosis

What Is Musculoskeletal Tuberculosis?

Tuberculosis is caused by an infectious bacterium called Mycobacterium tuberculosis. It is a severe infectious airborne disease. When this infectious disease, tuberculosis (TB), spreads into the bone and its surrounding parts, it is said to be skeletal tuberculosis. It is also called bone tuberculosis. This infectious bacteria can travel from the lungs through blood to the bone, lymph nodes, joints, and spine. Bone tuberculosis usually affects the musculoskeletal system, which consists of joints, muscles, bones, ligaments, tendons, and cartilage. Among these, spinal tuberculosis is the most common type of skeletal tuberculosis (when mycobacterium tuberculosis spreads to the spinal cord). Spinal tuberculosis is also known as Pott's disease or tuberculosis spondylitis.

What Are the Causes of Musculoskeletal Tuberculosis?

• Musculoskeletal tuberculosis is caused by the infectious bacterium Mycobacterium tuberculosis.

• Some studies have shown that skeletal tuberculosis may not be caused by droplets spread in the air. The infection may be affected through blood if there is contact with the body fluids or pus of the infected person.

• It may also be caused by pulmonary tuberculosis, as the infections in the lung can easily spread through blood vessels through bone, spine, and joints, resulting in infection spread mainly in the long bones and in spinal vertebrae.

• This rare type of musculoskeletal tuberculosis is mostly seen in immunocompromised patients like AIDS (acquired immunodeficiency syndrome) patients.

What Are the Symptoms of Musculoskeletal Tuberculosis?

Musculoskeletal tuberculosis is very hard to diagnose as it shows the symptoms only when the infection is severe and goes to the advanced stage. Some of the symptoms of musculoskeletal tuberculosis include:

• Severe back pain.

• Soft tissue swelling.

• Stiffness.

• Spinal abscess.

• Inflammation of joints and back.

• Difficulty in walking or moving, mainly in children.

• Tuberculosis-related meningitis.

• Neurological disorders.

• Weakness of the muscle.

• Spinal or bone deformities.

• Paralysis (paraplegia or tetraplegia).

• Kyphosis.

• Shortening of limbs in children.

• Fatigue.

• Fever.

• Weight loss.

• Sweating at night.

• Osteoarticular manifestations.

• The feeling of dislodgement of bones.

• Destruction of the discs and vertebrae.

• Spinal hump.

• Carpal tunnel syndrome.

• Uneasiness in the thoracic area.

• Wrist pain.

• Painful joints.

• Loss of muscle mass

• Reduced range of motion in the affected area.

• Enlarged lymph nodes.

• Ulcers.

• Cold abscess.

• Loss of appetite.

How Is Musculoskeletal Tuberculosis Diagnosed?

Doctors may diagnose musculoskeletal tuberculosis by using various methods. Some of them include:

• Bacterial Culture - People with bone tuberculosis may have underlying lung infections. So the doctors may suggest the test for mycobacterium tuberculosis in the sputum or blood sample.

• Body Fluid Test - Doctors usually recommend drawing pleural fluid(the fluid that protects and surrounds the lungs) to check infections. They also recommend drawing synovial fluid and cerebrospinal fluid to check for musculoskeletal tuberculosis.

• Polymerase Chain Reaction (PCR) Test - Doctors may recommend polymerase chain reaction tests to boost the mycobacterium's genetic material to check for infections in a small number of fluids.

• Biopsy - Doing a biopsy procedure for the affected parts may also indicate if there is any tuberculosis infection at the site.

• Radiological Test - Doctors may recommend CT (computed tomography) scan, X- rays, and MRI (Magnetic Resonance Imaging) for diagnosis of musculoskeletal tuberculosis if the person has any symptoms of bone deformities.

• Immunological Test - These tests are recommended by doctors to diagnose skeletal tuberculosis in AIDS patients.

How Is Musculoskeletal Tuberculosis Treated?

If musculoskeletal tuberculosis is left untreated, it may cause very severe complications or even death. This musculoskeletal tuberculosis can be treated by the following:

• Anti-tuberculosis Drugs - Medications are the first line of treatment for musculoskeletal tuberculosis. Rifampicin, Kanamycin, Isoniazid, Streptomycin, Ethambutol, Pyrazinamide, Cycloserine, and Protionamide are the most commonly used anti-tuberculosis drugs. These anti-tuberculosis drugs will penetrate the cerebrospinal fluid (CSF) and kill the bacteria. The anti-tuberculosis drugs may take 6 to 12 months to eradicate skeletal tuberculosis.

• Corticosteroids - Inflammation of the spinal cord or heart due to musculoskeletal tuberculosis may be prevented by prescribing corticosteroids.

• XDR-TB - It is drug-resistant tuberculosis. This treatment includes all the drugs that are resistant to mycobacterium tuberculosis. This treatment contains drugs like polypeptides, thiazides, aminoglycosides, and para-aminosalicylic acid.

• MDR- Therapy - It is a combination of anti-tuberculosis drugs with different drug actions. It is the most suitable therapy to treat musculoskeletal tuberculosis.

• Surgery - In most severe cases of musculoskeletal tuberculosis, the doctors may recommend surgical removal of the infected part.

What Is the Preventive Measure for Musculoskeletal Tuberculosis?

• People with musculoskeletal tuberculosis should stop using tobacco and tobacco products.

• People with musculoskeletal tuberculosis should avoid excessive consumption of alcohol.

• They should also reduce the use of refined products.

• It is better if the person infected with musculoskeletal tuberculosis avoids eating greasy foods like chips, onion, chicken, fried foods, and food that contain high saturated fat.

Conclusion

Mycobacterium tuberculosis is the most infectious bacteria that even causes death when get infected. So early detection of the infection can reduce the most complicated effects of tuberculosis. The prognosis of skeletal tuberculosis depends on its severity. Musculoskeletal tuberculosis can be prevented by diagnosing pulmonary tuberculosis as soon as possible, as it is the major cause of developing skeletal tuberculosis through the bloodstream by spreading the bacteria. This bone tuberculosis may affect the quality of life of the person completely. Reaching out to healthcare professionals if any of the above symptoms are observed may stop the disease-causing.