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What is the cure for bone tuberculosis?

Friday, 29 December 2006
Answered by: Dr. Anuj Sharma
Consultant Microbiologist
Sir Ganga Ram Hospital
Delhi

Q. I am 32 years old and go to the gym every day for the last 3 years. Recently I started jogging for about 4 km. One day I suddenly got pain in the left lower leg. After 4 days, I was not able to walk. I consulted an orthopaedic surgeon who took x-ray and blood tests, which came out normal. He gave me a medicine, but the pain continued. I consulted another doctor who did MRI, and bone scan, where it was found that some thing is wrong with the left tibia. He said that I had to undergo a small surgery. After the surgery he told me that some bad materials from the left tibia were removed and he took a piece of bone for biopsy. The biopsy reported nothing, but doctors think that I might have TB. I started taking medicine for TB. But now the pain is gone, but surgery stitches and hole on the bone gives pain. Is it bone TB? Is it curable? For how many days do I need to take the medicine?

A.  TB of the bones or joint TB is known as skeletal TB, and may present acutely or subacutely. Vertebral TB may go unrecognised for months to years because of its indolent nature. The common sites involved in bone TB are the large weightbearing bones or joints including the vertebrae, hip and knee. Destruction of the bones with deformity is a late sign of TB. Serology has a limited role in diagnosis of TB, due to poor sensitivity and specificity. Radio-nuclide bone scans may be helpful, but definitive diagnosis can only be made with aspiration of material / biopsy of the affected area, followed by microbiological invesigations - AFB staining, AFB culture / sensitivity and/or nucliec acid amplification tests like PCR or geneprobe. It is curable, and the duration of treatment is usually from 9 months to one year.

A.  TB of the bones or joint TB is known as skeletal TB, and may present acutely or subacutely. Vertebral TB may go unrecognised for months to years because of its indolent nature. The common sites involved in bone TB are the large weightbearing bones or joints including the vertebrae, hip and knee. Destruction of the bones with deformity is a late sign of TB. Serology has a limited role in diagnosis of TB, due to poor sensitivity and specificity. Radio-nuclide bone scans may be helpful, but definitive diagnosis can only be made with aspiration of material / biopsy of the affected area, followed by microbiological invesigations - AFB staining, AFB culture / sensitivity and/or nucliec acid amplification tests like PCR or geneprobe. It is curable, and the duration of treatment is usually from 9 months to one year.

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