foot and ankle Surgeon

Bone Tuberculosis: Causes, Symptoms, Diagnosis, and Treatment By Dr. Ishwar Meena, Orthopedic Surgeon & Foot and Ankle Specialist, Jaipur Tuberculosis is commonly known as a lung disease, but it can also affect bones and joints. This condition, known as bone tuberculosis (skeletal TB), often progresses slowly and may go unnoticed in its early stages. If left untreated, it can lead to serious complications such as joint destruction, spinal deformity, and long-term disability. As an orthopedic surgeon, I frequently see patients with persistent bone or joint pain that does not improve with routine treatment. In some cases, the underlying cause turns out to be bone tuberculosis. Early diagnosis and timely treatment are essential for a good recovery. What Is Bone Tuberculosis? Bone tuberculosis occurs when Mycobacterium tuberculosis bacteria spread from another part of the body—most commonly the lungs—through the bloodstream and settle in bones or joints. The disease develops gradually, which is why symptoms are often mild in the beginning. The spine is the most commonly affected area, a condition known as Pott’s disease. Other frequently involved sites include the hip, knee, and ankle joints, which can significantly affect mobility if not treated early. Causes of Bone TB Bone TB is caused by the same bacteria responsible for pulmonary tuberculosis. It usually develops when: Pulmonary TB is untreated or partially treated The immune system is weakened, allowing the infection to spread Who Is at Risk? Bone tuberculosis is more likely in individuals with: A history of tuberculosis Diabetes, HIV, or weakened immunity Poor nutritional status Delayed medical consultation for persistent bone or joint pain Prolonged exposure to crowded or unhygienic living conditions Symptoms of Bone Tuberculosis Symptoms often appear gradually and may worsen over time. Local symptoms Persistent pain in the affected bone or joint Swelling and stiffness Reduced range of movement Difficulty walking or standing General symptoms Low-grade fever Night sweats Unexplained weight loss Fatigue and weakness Advanced complications If diagnosis is delayed, bone TB can lead to: Abscess formation Spinal deformity Nerve compression causing weakness or paralysis Permanent joint damage How Is Bone Tuberculosis Diagnosed? Bone TB can resemble arthritis or other bone disorders, making diagnosis challenging. A detailed evaluation may include: X-rays, CT scans, or MRI to assess bone involvement Biopsy or tissue sampling to confirm tuberculosis infection Blood tests to detect inflammation TB-specific screening tests Early diagnosis significantly improves treatment outcomes and reduces complications. Treatment of Bone Tuberculosis Medical Treatment The primary treatment for bone TB is long-term anti-tuberculosis medication. Most patients require a combination of medicines for 6 to 12 months or longer, depending on disease severity. Strict adherence to the treatment plan is essential to prevent relapse or drug resistance. Surgical Treatment Surgery is required only in selected cases, such as: Severe bone destruction Spinal instability Abscess formation Nerve compression Surgical procedures help remove infected tissue and stabilize the affected bones. Recovery and Rehabilitation Once the infection is controlled, physiotherapy and rehabilitation play a vital role in restoring joint movement, strength, and function. Proper nutrition and regular follow-up visits further support complete recovery. When Should You Consult an Orthopedic Specialist? You should seek medical advice if you experience: Persistent bone or joint pain lasting several weeks Pain associated with fever or unexplained weight loss Difficulty walking or reduced joint movement Early consultation can prevent serious complications and permanent disability. Doctor’s Advice Bone tuberculosis is a serious but completely treatable condition. With early diagnosis, appropriate medication, and proper follow-up care, most patients recover well and regain normal function. If you have ongoing bone or joint pain, timely evaluation by an orthopedic specialist is essential for protecting your long-term bone health. — Dr. Ishwar MeenaOrthopedic Surgeon & Foot and Ankle Specialist, Jaipur