Mar 22, 2023
Tuberculosis of Bone & Joints is one of the most crucial topics which you must study in-depth during your Orthopedics preparation. Questions from this topic are commonly asked in the exam.
This article will help you understand every aspect of the Tuberculosis of Bone & Joints and will help you get an edge in your NEET PG exam preparation. So, let’s get started!
Tuberculosis is the disease of the nation. 1/3 of the infection stays in the community. TB of bone and joint is not very common. It comes from the lungs or the lymph nodes. Every infection comes from blood (hematogenous spread) and paucibacillary. It is difficult to isolate tubercular bacilli. Order of spread of infection Spine (Pott's spine), Hip, Knee. TB of the shoulder is called Caries Sicca. Tuberculosis of the fingers produces a web-like image called Spina Ventosa.
The lower half of the upper vertebra and the upper half of the lower vertebra and the disc, they arise from the same mesodermal somite. Thus they have the same segmental artery supplying it. So, the tubercular bacilli always involves two vertebrae and one disc called as para discal lesion. It's also called a disease involving bone and the cartilage. TB involves the vertebral body, which is anterior to neural tissue. So, it's an anterior disease. Single vertebra and posterior elements involvement is not TB. The vertebra, the pedicles, lamina, spinous process or the transverse process, all these are called as the posterior elements of the spine.
Spinous processes are rare but the rarest is Facet joints.
Is a 2 vertebral disease, involves vertebra and disc, bone and cartilage, paradiscal and its anterior disease. Posterior elements and single vertebral disease is malignancy. In the spine most commonly involves the dorsal lumbar spine, or dorsal lumbar junction (D11-D12 and L1)
Every vertebra has 2 eyes and one nose. Whenever malignancy destroys vertebra, firstly it affects the pedicle (one eye). When one eye is gone, it is called as winking owl sign. When both the eyes are gone , it is called blind bat sign.
It means abscess erodes the vertebra.
First symptom is back pain. First sign is tenderness. First neurological sign is an increased deep tendon reflex.
Anti tubercular therapy plus surgery (when indicated). Rifampicin is the drug of choice. For bacterium tuberculosis, combination therapy is the best.
The disease is on the anterior side, so the approach is to enter from the left side. There are 2 approaches
|Feature||Better prognosis||Poor prognosis|
|Degree of cord involvement||Partial||Complete (grade IV)|
|Duration of cord involvement||Shorter||Longer (> 12 months)|
|Type||Early onset||Late onset|
|Kyphotic deformity||< 60 degree||> 60 degree|
|Cord on MRI||Normal||Myelomalacia/ syrinx (cord damaged)|
|Preoperative||Wet lesion||Dry lesion|
Insert implant inside the bone directly. The bone will grow over the porous elements and attains a very strong implant bone contact called as uncemented replacement or can have layers of cement between the implant and the bone called as cemented replacement.
Only the femoral part with the head and the neck is half replacement. When replaced half, it can be 2 types
When replace acetabulum along with femur
Osteopenic area in between trabeculae is labelled as Babocks triangle. It is deficient in the monocyte macrophage system, which causes hip infection.
There is gradual pain because Tb is chronic infection and also there is limp and flexion
Tuberculosis in the initial stage will have limp and pain but if left untreated, it will develop a triple deformity
We hope this article has helped you understand the Tuberculosis of Bone & Joints in detail. For more such information, download the PrepLadder app and study with Dream Team Next Edition (India’s top Medical facutly).
Get access to all the essential resources required to ace your medical exam Preparation. Stay updated with the latest news and developments in the medical exam, improve your Medical Exam preparation, and turn your dreams into a reality!
The most popular search terms used by aspirants