Bone Tuberculosis (TB) Diagnosis cannot be confirmed, do we opt for surgery or TB medication?


My name is (…) from Australia. My nephew – (…), (male) aged 16 year, living in Bangladesh, has been suffering an acute pain in his spine. Doctor in Bangladesh wasn’t able to unambiguously diagnose his disease, however based on some of the medical investigation such as MRI scan and assessing the symptoms they strongly suspect that (my nephew) has been suffering from Bone TB. As the diagnosis was not unequivocal so the prescribed course of the treatment given by the doctors in Bangladesh doesn’t build a solid confidence in us. In that circumstance my sister brought him to Hyderabad, India as India is deemed to be better than Bangladesh in regards to medical science. However, the outcome is almost absolutely identical. In this circumstance we are seriously confused and cannot take our decision, whether we should go for surgery or TB medication. We are even thinking about taking the patient to Bangkok as Bangkok is even better than India.
Please give me a guideline.
Kindest regards,

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Ahmed Fawzy
9:38 pm

I need to see the MRI before I can give you a perfect answer, however if it was TB then he will need both TB treatment + surgery as neglected to must be corrected later by surgery , conclusion is that surgery is a must if it is indeed TB
Good Luck

Dr.Honey Arora
8:54 am

Thanks for the query..

If bone tuberculosis is suspected then investigation like Radionuclide bone scans can help..
But for a definitive diagnosis you should go for aspiration cytology along with AFB staining and Polymerase chain reaction or generobe test..

Once the diagnosis is confirmed then treatment can be appropriately planned like it should be conservative or surgical..

Also please upload the MRI SCAN and along with it other investigation reports that are done and the treatment prescription..

Hope this helps..

Masr Fawzy
12:26 pm

You need to do Mantoux tuberculin skin test , and blood culture to confirm the diagnosis,
Aspiration is gonna be diagnostic as well

Ayman Darrag
4:24 pm

You need to consider polymerase chain reaction for diagnosis as early as possible , then medical treatment should be followed ,mostly 80-90%of cases respond to anti tb drugs and surgical treatment is necessary only in case of complications..