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Is there any treatment for bone TB?

Q: My 31 years old sister had twisted her leg 5 months ago and since then she is feeling pain in her right ankle. She took Seredic Ap and many therapies like physiotherapy and meditation but in vain. Then she got MRI done, which reported bone TB in tibia and tibia bone joint. Is there any treatment for it and how much time will it take?

A:Quite often patients attribute the onset of symptoms in bones and joints to some episode of injury. Even a simple twist that did not incapacitate them momentarily also gets attributed to the onset of pain. I am glad that when the symptoms did not resolve your doctor has advised further investigation to arrive at a diagnosis. Your sister’s diagnosis of tuberculosis of Tibia on the MRI is an imaging diagnosis. This is not a 100% confirmed diagnosis. But I do hope the doctor has correlated the clinical picture with the MRI picture and then made the diagnosis. Assuming the diagnosis to be correct (Don’t worry, by and large it is usually correct) the treatment is quite straightforward. A number of physicians think that treatment needs to be for 1 or one and a half years. This is not necessary. A number of doctors, especially Surgeons, will also tell you that bone TB is different; it needs longer treatment, as the drugs do not reach the bones easily. These are all myths not backed by scientific evidence. As per WHO recommendation and as per the recommendation of the Revised National TB Control Programme (RNTCP) guidelines your sister’s treatment will need to be in two phases. 2 months of intensive phase and 4 months of Continuation phase. Most cases settle with this. Symptoms settle early and then patients start feeling that they should not unnecessarily take the full course. This is dangerous as this encourages relapse and also encourages drug resistance. With the current drugs that are available TB is completely treatable. So, you do not have to worry about the diagnosis of TB. But please ensure that she does not drop out of the full course of treatment. In case she does not respond in the next two to three months please have her case reviewed and if found necessary by the doctor a biopsy may be required for confirmation.

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