Skeletal Tuberculosis: Clinical Manifestations and Symptoms

Skeletal tuberculosis (TB) is a rare but serious form of extrapulmonary tuberculosis that affects the bones and joints. It accounts for approximately 10% of all extrapulmonary TB cases and primarily involves the spine, long bones, and joints.

Clinical Manifestations

Spinal Tuberculosis (Pott's Disease)

• Most common form of skeletal TB, affecting the vertebrae.
• Gradual onset with persistent back pain.
• Neurological deficits due to spinal cord compression.
• Kyphosis (hunchback deformity) in advanced cases.

Joint Tuberculosis

• Commonly affects weight-bearing joints like the hip and knee.
• Progressive joint pain and swelling.
• Restricted movement and joint stiffness.
• May mimic chronic arthritis.

Long Bone Tuberculosis

• Involves femur, tibia, and humerus.
• Localized pain and swelling.
• Formation of cold abscesses.
• Pathological fractures in severe cases.

Symptoms

• Persistent pain in affected bones or joints.
• Swelling and tenderness.
• Low-grade fever and night sweats.
• Weight loss and fatigue.
• Neurological symptoms in spinal involvement.

Diagnosis and Management

Diagnosis involves imaging studies (X-ray, MRI, CT scan), biopsy, and microbiological tests. Treatment includes a prolonged course of anti-tubercular therapy (ATT) and, in severe cases, surgical intervention.