This document discusses the spread patterns and treatment of tuberculosis of bones and joints. Tuberculosis can spread from bones to surrounding tissues through various routes, such as along blood vessels, nerves, fascial planes and lymph nodes. Diagnosis involves x-rays, CT scans, MRI and PET scans. Antituberculous treatment is the mainstay for treating tuberculosis of bones and joints and is usually sufficient for uncomplicated cases. Surgery may be needed to adequately decompress abscesses, maintain spinal stability through fusion or instrumentation, or correct deformities.

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• VEINS
PELVIC URINARY
BLADDER PROSTATE INTERNAL VERTEBRAL VENOUS PLEXUSES [1]

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10. region Pre vertebral
spread
Paravertebral
spread
Along musculo
fascial planes
Along neuro
vascular bundles
cervical Retropharyngeal
abscess
Paravertebral
abscess
Neck (along
SCM),posterior
triangle of neck
Axilla (along
brachial plexus
bundle)
thoracic Mediastinal
abscess
Paravertebral
abscess
Lumbar abscess
Psoas abscess
Anterior chest
wall
Posterior chest
wall
Axilla( along
thoracic spinal
nerves)
lumbar Pre vertebral
abscess
Paravertebral
abscess
Lumbar abscess
Psoas abscess

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17. • X RAY
• CT SCAN
• MRI
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• 18-FDG PET SCAN

18. INITIATION PHASE– 2 MONTHS CONTINUATION PHASE-- 7 MONTHS
H
R
Z
E
H
R
• MDR TB
• XDR TB
• TDR TB
ATT IS THE MAINSTAY OF TREATMENT IN TUBERCULOSIS OF BONE AND JOINTS.
ATT ALONE SUFFICIENT TO TREAT UNCOMPLICATED TB
EVEN AN UNCOMPLICATED COLD ABSCESS CAN BE RESOLVED WITH ATT ALONE

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21. OBJECTIVES OF SURGICAL
TREATMENT
• ADEQUATE DECOMPRESSION (
DEBRIDEMENT AND DRAINAGE OF COLD
ABSCESS
• MAINTAINANCE OF STABILITY (
FUSION OR SPINE FIXATION WITH
INSTRUMENTATION)
• CORRECTION OR HALT PROGRESSION OF
DEFORMITY