Bone Tuberculosis

Bone tuberculosis is mostly secondary to pulmonary TB, though some patients have no prior pulmonary history (occult infection). Tubercle bacilli usually first affect the lungs, then spread hematogenously to many systems, causing skeletal, urinary, and digestive TB. Thus bone TB is not an isolated lesion but a systemic disease manifest locally.

Common Symptoms

Elbow deformity; anorexia; low fever; work fatigue; weight loss

Causes and Pathogenesis

Bone TB is a purulent destructive lesion caused by tubercle bacilli invading bone or joints. Traditional Chinese medicine calls it bone consumption because it depletes qi, blood, and fluids causing emaciation and debility. After pus forms, it can track to distant sites forming cold (gravitational) abscesses that discharge flocculent material, hence also called flowing phlegm. It is common in children and adolescents, mostly under 30, peak at ages 3-5. Sites are weight-bearing, mobile, and prone to strain: the spine is most common (~half), then knee, hip, elbow, and ankle; limb diaphyses, sternum, ribs, and skull are rare.

Treatment

Surgical treatment, drug therapy, supportive therapy

Preventive Measures

1. Control system: Establish TB control organizations at all levels; survey epidemics, plan programs, educate, train staff, and evaluate outcomes. 2. Treatment setting: Effective anti-TB therapy cures disease and converts sputum negative, eliminating the source; home and hospital treatment are equally effective. 3. Case finding: Sputum-positive patients are the source; one smear-positive case infects 5-10 people yearly. Cure helps control the epidemic. Actively search asymptomatic cases; mass chest X-rays detect early cases. 4. Case management: Register pulmonary TB patients; long-term treatment demands safe, effective, compliant, non-resistant, affordable regimens. 5. BCG vaccination: Live attenuated M. bovis vaccine gives acquired immunity to uninfected neonates, children, and adolescents. Controlling sources, cutting transmission, and enhancing immunity are the basic principles.

Department to Visit

It is recommended to visit the Orthopedic Surgery department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.