Tuberculosis, an infection caused by the organism Mycobacterium tuberculosis, is known to affect all parts of the human body, including the bones and joints. When the spine is involved, the condition is known as Pott’s disease. This disease is more common in the developing countries as compared to the developed nations, because the latter have higher living standards and their populations live under more hygienic conditions.
The disease is usually transmitted through a mucus aerosol that contaminates the air when an infected person coughs or sneezes. Bovine tuberculosis can spread by drinking the unpasteurized milk of a cow suffering from tuberculosis. Usually, the focus of the infection is the gastrointestinal tract or the lungs. People with low immunity tend to suffer from tuberculosis of the bones and joints or miliary tuberculosis (a diffused form of the disease involving multiple organs in the body simultaneously).
The intervertebral joints of the lumbar or thoracic spine, the hip, and the knee are the joints that are commonly affected by tuberculosis. Although the bones and the joints can get infected separately, they tend to get infected together by the tubercle bacilli. If the treatment of this condition is not started immediately, the entire joint can get destroyed. Following this, secondary infection by pus forming bacteria can lead to the formation of a tubercular abscess that drains naturally through abnormal passages leading to the surface of the skin.
Healing is generally by the formation of scar tissue, which makes the joint unsteady, deformed, or stiff. The symptoms of the disease are typical of tuberculosis. The patient looks sick and suffers from weight loss. He loses his appetite and may have low grade fever, especially in the evenings, along with night sweats. The involved joint gets swollen and becomes extremely painful. The muscles in relation to the joint may go into spasm and also waste away. If there is lung involvement, there may be cough along with bloody phlegm.
The condition is diagnosed by an X-raying the affected bone or joint. A positive Mantoux test is confirmatory. Serological tests may also be useful in diagnosing the condition. Treatment involves adequate rest, immobilization of the affected joint, and the administration of anti-tubercular drugs. If there is an abscess, it should be drained to facilitate quicker healing. Antibiotics may have to be given to take care of the secondary infections. The patient is advised a high protein diet and is asked to relocate to a pollution-free area for at least a few months.