lecture 1.pptx

The skeletal system Under the supervision of Dr. Abdelrahman Badawy Farouk  01. Bones of the skeleton, classification, 02. Development and and function. growth of bones. 03. Bones of the upper limb. 04. Bones of the lower limb. 05. Bone tub...

The skeletal system Under the supervision of Dr. Abdelrahman Badawy Farouk  01. Bones of the skeleton, classification, 02. Development and and function. growth of bones. 03. Bones of the upper limb. 04. Bones of the lower limb. 05. Bone tuberculosis. Axial Skeleton Axial skeleton is made up of the 80 bones within the central core of your body. This includes bones in your skull (cranial and facial bones), ears, neck, back (vertebrae, sacrum, and tailbone), and ribcage (sternum and ribs). Your axial skeleton protects your brain, spinal cord, heart, lungs, and other important organs. Function Axial skeleton provides support and cushioning for your brain, spinal cord, and organs in your body. Muscles in your body that move your head, neck, and trunk attach to your axial skeleton. These muscles help you breathe and steady parts of your appendicular skeleton. Axial Skeleton (80 bones) Appendicular skeleton There are 126 bones in the human appendicular skeleton, includes the skeletal elements within the shoulder and pelvic girdles, upper and lower limbs, and hands and feet. function The appendicular skeleton supports the attachment and functions of the upper and lower limbs of the human body pendicular Skeleton (126 bones) Types of Bones The long bones, longer than they are There are flat bones in the skull (occipital, wide, include the femur (the longest parietal, frontal, nasal, lacrimal, and vomer), bone in the body) as well as relatively the thoracic cage (sternum and ribs), and the small bones in the fingers. Long bones pelvis (ilium, ischium, and pubis). The function function to support the weight of the of flat bones is to protect internal organs such body and facilitate movement. as the brain, heart, and pelvic organs. They often have a fairly Sesamoid bones are bones Short bones are about as complex shape, which helps embedded in tendons. These long as they are wide. protect internal organs. For small, round bones are Located in the wrist and example, the vertebrae, commonly found in the ankle joints, short bones irregular bones of the tendons of the hands, knees, provide stability and some vertebral column, protect and feet. Sesamoid bones movement. The carpals in the spinal cord. function to protect tendons the wrist and the tarsals in from stress and wear. the ankles are examples of short bones. Bone Development & Growth Bone development continues throughout adulthood. Even after adult stature is attained, bone development continues for repair of fractures and for remodeling to meet changing lifestyles. Osteoblasts, osteocytes and osteoclasts are the three cell types involved in the development, growth and remodeling of bones. Osteoblasts are bone-forming cells, osteocytes are mature bone cells and osteoclasts break down and reabsorb bone. There are two types of ossification: intramembranous and endochondral. Intramembranous ossification involves the replacement of sheet-like connective tissue membranes with bony tissue. Bones formed in this manner are called intramembranous bones. They include certain flat bones of the skull and some of the irregular bones. The future bones are first formed as connective tissue membranes. Osteoblasts migrate to the membranes and deposit bony matrix around themselves. When the osteoblasts are surrounded by matrix they are called osteocytes. Endochondral ossification involves the replacement of hyaline cartilage with bony tissue. Most of the bones of the skeleton are formed in this manner. These bones are called endochondral bones. In this process, the future bones are first formed as hyaline cartilage models. During the third month after conception, the perichondrium that surrounds the hyaline cartilage "models" becomes infiltrated with blood vessels and osteoblasts and changes into a periosteum. The osteoblasts form a collar of compact bone around the diaphysis. At the same time, the cartilage in the center of the diaphysis begins to disintegrate. Osteoblasts penetrate the disintegrating cartilage and replace it with spongy bone. This forms a primary ossification center. Ossification continues from this center toward the ends of the bones. After spongy bone is formed in the diaphysis, osteoclasts break down the newly formed bone to open up the medullary cavity. The Scapula The scapula is also known as the shoulder blade. It articulates with the humerus at the glenohumeral joint, and with the clavicle at the acromioclavicular joint. In doing so, the scapula connects the upper limb to the trunk. It is a triangular, flat bone, which serves as a site for attachment for many (17!) muscles. Costal Surface The costal (anterior) surface of the scapula faces the ribcage. It contains a large concave depression over most of its surface, known as the subscapular fossa. The subscapularis (rotator cuff muscle) originates from this fossa. Originating from the superolateral surface of the costal scapula is the coracoid process. It is a hook-like projection, which lies just underneath the clavicle. Three muscles attach to the coracoid process: the pectoralis minor, coracobrachialis, and the short head of the biceps brachii. Lateral Surface The lateral surface of the scapula faces the humerus. It is the site of the glenohumeral joint, and of various muscle attachments. Its important bony landmarks include:  Glenoid fossa – a shallow cavity, located superiorly on the lateral border. it articulates with the head of the humerus to form the glenohumeral (shoulder) joint.  Supraglenoid tubercle – a roughening immediately superior to the glenoid fossa. The place of attachment of the long head of the biceps brachii.  Infraglenoid tubercle – a roughening immediately inferior to the glenoid fossa. The place of attachment of the long head posterior surface The posterior surface of the scapula faces outwards. It is a site of origin for the majority of the rotator cuff muscles of the shoulder. It is marked by:  Spine – the most prominent feature of the posterior scapula. It runs transversely across the scapula, dividing the surface into two.  Acromion – projection of the spine that arches over the glenohumeral joint and articulates with the clavicle at the acromioclavicular joint.  Infraspinous fossa – the area below the spine of the scapula, it displays a convex shape.  Supraspinous fossa – the area above the spine of the scapula, it is much smaller than the infraspinous fossa, and is more convex in shape. The Clavicle The clavicle (collarbone) extends between the manubrium of the sternum and the acromion of the scapula. It is classed as a long bone and can be palpated along its length. In thin individuals, it is visible under the skin. The clavicle has three main functions:  Attaches the upper limb to the trunk as part of the ‘shoulder girdle’.  Protects the underlying neurovascular structures supplying the upper limb.  Transmits force from the upper limb to the axial 1. Sternal skeleton (medial) End The sternal end contains a large facet – for articulation with the manubrium of the sternum at the sternoclavicular joint. The inferior surface of the sternal end is marked by a rough oval depression for the costoclavicular ligament (a ligament of the SC joint). 2. Shaft The shaft of the clavicle acts a point of origin and attachment for several muscles – deltoid, trapezius, subclavius, pectoralis major, sternocleidomastoid and sternohyoid 3. Acromial (lateral) End The acromial end houses a small facet for articulation with the acromion of the scapula at the acromioclavicular joint. It also serves as an attachment point for two ligaments: Conoid tubercle – attachment point of the conoid ligament, the medial part of the coracoclavicular ligament. Trapezoid line – attachment point of the trapezoid ligament, the lateral part of the coracoclavicular ligament. The coracoclavicular ligament is a very strong structure, effectively suspending the weight of the upper limb from the clavicle. he Humerus The humerus is a long bone of the upper limb, which extends from the shoulder to the elbow. The proximal aspect of the humerus articulates with the glenoid fossa of the scapula, forming the glenohumeral joint. Distally, at the elbow joint, the humerus articulates with the head of the radius and trochlear notch of the ulna. The proximal humerus is marked by a head, anatomical neck, surgical neck, greater and lesser tuberosity and intertubercular sulcus. 1. The upper end of the humerus consists of the head. This faces medially, upwards and backwards and is separated from the greater and lesser tuberosities by the anatomical neck. 2. The greater tuberosity is located laterally on the humerus and has anterior and posterior surfaces. It serves as an attachment site for three of the rotator cuff muscles – supraspinatus, infraspinatus and teres minor – they attach to superior, middle and inferior facets (respectively) on the greater tuberosity. 3. The lesser tuberosity is much smaller, and more medially located on the bone. It only has an anterior surface. It provides attachment for the last rotator cuff muscle – the subscapularis. Separating the two tuberosities is a deep groove, known as the intertubercular sulcus. The tendon of the long head of the biceps brachii emerges from the shoulder joint and runs through this groove. * The edges of the intertubercular sulcus are known as lips. Pectoralis major, teres major and latissimus dorsi insert on the lips of the intertubercular sulcus. * The surgical neck extends from just distal to the tuberosities to the shaft of the humerus. The axillary nerve and circumflex humeral vessels lie against the bone here. Shaft The shaft of the humerus is the site of attachment for various muscles. Cross section views reveal it to be circular proximally and flattened distally. On the lateral side of the humeral shaft is a roughened surface where the deltoid muscle attaches. This is known is as the deltoid tuberosity. The radial (or spiral) groove is a shallow depression that runs diagonally down the posterior surface of the humerus, parallel to the deltoid tuberosity. The radial nerve and profunda brachii artery lie in this groove. The following muscles attach to the humerus along its shaft: * Anteriorly – coracobrachialis, deltoid, brachialis, brachioradialis. * Posteriorly – medial and lateral heads of the triceps (the spiral groove demarcates their respective origins). Distal Region The lateral and medial borders of the distal humerus form medial and lateral supraepicondylar ridges. The lateral supraepicondylar ridge is more roughened, providing the site of common origin of the forearm extensor muscles. Immediately distal to the supraepicondylar ridges are extracapsular projections of bone, the lateral and medial epicondyles. Both can be palpated at the elbow. The medial is the larger of the two and extends more distally. Distally, the trochlea is located medially, and extends onto the posterior aspect of the bone. Lateral to the trochlea is the capitulum, which articulates with the radius. Also located on the distal portion of the humerus are three depressions, known as The Ulna The ulna is a long bone in the forearm. It lies medially and parallel to the radius, the second of the forearm bones. The ulna acts as the stabilising bone, with the radius pivoting to produce movement. Proximal Osteology and Articulation The proximal end of the ulna articulates with the trochlea of the humerus. To enable movement at the elbow joint, the ulna has a specialised structure, with bony prominences for muscle attachment. mportant landmarks of the proximal ulna 3. Trochlear notch – formed by the olecranon and coronoid process. It is wrench shaped, and articulates with the trochlea of the humerus. 4. Radial notch – located on the lateral surface of the trochlear notch, this area articulates with the head of the radius. 5. Tuberosity of ulna – a roughening immediately distal to the coronoid process. It is where the brachialis muscle attaches. Shaft of the Ulna The ulnar shaft is triangular in shape, with three borders and three surfaces. As it moves distally, it decreases in width. The three surfaces: 1. Anterior – site of attachment for the pronator quadratus muscle distally. 2. Posterior – site of attachment for many muscles. 3. Medial – unremarkable. The three borders: 1. Posterior – palpable along the entire length of the forearm posteriorly 2. Interosseous – site of attachment for the interosseous membrane, which spans the distance between the two forearm bones. 3. Anterior – unremarkable. Distal Osteology and Articulations The distal end of the ulna is much smaller in diameter than the proximal end. It is mostly unremarkable, terminating in a rounded head, with distal projection – the ulnar styloid process. The head articulates with the ulnar notch of the radius to form the distal radio- The Radius The radius is a long bone in the forearm. It lies laterally and parallel to ulna, the second of the forearm bones. The radius pivots around the ulna to produce movement at the proximal and distal radio-ulnar joints. The radius articulates in four places: 1. Elbow joint – Partly formed by an articulation between the head of the radius, and the capitulum of the humerus. Proximal radioulnar joint – An articulation between the radial head, and the radial notch of the ulna. 2. Wrist joint – An articulation between the distal end of the radius and the carpal bones. 3. Distal radioulnar joint – An articulation between the ulnar notch and the head of the ulna. Proximal End The proximal end of the radius articulates in both the elbow and proximal radioulnar joints. Important bony landmarks include the head, neck and radial tuberosity: 1. Head of radius – A disk shaped structure, with a concave articulating surface. It is thicker medially, where it takes part in the proximal radioulnar joint. 2. Neck – A narrow area of bone, which lies between the radial head and radial tuberosity. 3.Radial tuberosity – A bony projection, which serves as the place of attachment of the biceps brachii muscle. Shaft The radial shaft expands in diameter as it moves distally. Much like the ulna, it is triangular in shape, with three borders and three surfaces. In the middle of the lateral surface, there is a small roughening for the attachment of the pronator teres muscle. Distal End In the distal region, the radial shaft expands to form a rectangular end. The lateral side projects distally as the styloid process. In the medial surface, there is a concavity, called the ulnar notch, which articulates with the head of ulna, forming the distal radioulnar joint. The distal surface of the radius has two facets, for articulation with the scaphoid and lunate carpal bones. This makes up the wrist joint. the Hand 1. Carpal Bones The carpal bones are a group of eight irregularly shaped bones. They are organised into two rows – proximal and distal: Proximal row: Scaphoid Lunate Triquetrum Pisiform (a sesamoid bone, formed within the tendon of the flexor carpi ulnaris) Distal row: Trapezium Trapezoid Capitate Hamate (has a projection on its palmar surface, known as the ‘hook of hamate’ In the proximal row, the scaphoid and lunate articulate with the radius to form the wrist joint (radiocarpal joint). The distal row of carpal bones 2. Metacarpal Bones The metacarpal bones articulate proximally with the carpals, and distally with the proximal phalanges. They are numbered, and each is associated with a digit: Metacarpal I – thumb. Metacarpal II – index finger. Metacarpal III – middle finger. Metacarpal IV – ring finger. Metacarpal V – little finger. Each metacarpal consists of a base, shaft and a head. The medial and lateral surfaces of the metacarpals are concave 3. Phalanges The phalanges are the bones of the fingers. Each phalanx consists of a base, a shaft and a head. The thumb has a proximal and distal phalanx, while the rest of the digits have proximal, middle and distal phalanges. The Pelvic Girdle The left and right hip bones (innominate bones, pelvic bones) are two irregularly shaped bones that form part of the pelvic girdle – the bony structure that attaches the axial skeleton to the lower limbs. The hip bones have three main articulations: 1. Sacroiliac joint – articulation with the sacrum. 2. Pubic symphysis – articulation between the left and right hip bones. 3.Hip joint – articulation with the head of femur. The hip bone is formed by three parts: the ilium, ischium, and pubis. At birth, these three components are separated by hyaline cartilage. They join each other in a Y-shaped portion of cartilage in the acetabulum. Bones of the Lower Limb Proximal The proximal aspect of the femur articulates with the acetabulum of the pelvis to form the hip joint. It consists of a head and neck, and two bony processes – the greater and lesser trochanters. 1. Head – articulates with the acetabulum of the pelvis to form the hip joint. It has a smooth surface, covered with articular cartilage (except for a small depression – the fovea – where ligamentum teres attaches). 2. Neck – connects the head of the femur with the shaft. It is cylindrical, projecting in a superior and medial direction. It is set at an angle of approximately 135 degrees to the shaft. 3. Greater trochanter – the most lateral palpable projection of bone that originates from the anterior aspect, just lateral to the neck.It is the site of attachment for many of the muscles in the gluteal region, such as gluteus medius, gluteus minimus and piriformis. 4. Lesser trochanter – smaller than the greater trochanter. It projects from the posteromedial side of the femur, just The Shaft The shaft of the femur descends in a slight medial direction. This brings the knees closer to the body’s centre of gravity, increasing stability. A cross section of the shaft in the middle is circular but flattened posteriorly at the proximal and distal aspects. On the posterior surface of the femoral shaft, there are roughened ridges of bone, called the linea aspera (Latin for rough line). This splits distally to form the medial and lateral supracondylar lines. The flat popliteal surface lies between them. Proximally, the medial border of the linea aspera becomes the pectineal line. The lateral border becomes the gluteal tuberosity, where the gluteus maximus attaches. Distally, the linea aspera widens and forms the floor of the popliteal fossa, the medial and lateral borders form the medial and lateral supracondylar lines. The medial supracondylar line ends at the adductor Distal The distal end of the femur is characterised by the presence of the medial and lateral condyles, which articulate with the tibia and patella to form the knee joint. Medial and lateral condyles – rounded areas at the end of the femur. The posterior and inferior surfaces articulate with the tibia and menisci of the knee, while the anterior surface articulates with the patella. The more prominent lateral condyle helps prevent the natural lateral movement of the patella; a flatter condyle is more likely to result in patellar dislocation. Medial and lateral epicondyles – bony elevations on the non-articular areas of the condyles. The medial epicondyle is the larger.The medial and lateral collateral ligaments of the knee originate from their respective epicondyles. Intercondylar fossa – a deep notch on the posterior surface of the femur, between the two condyles. It contains two facets for attachment of intracapsular knee ligaments; the anterior cruciate ligament (ACL) attaches to the medial aspect of the lateral condyle and the posterior cruciate The Tibia The tibia is the main bone of the lower leg, forming what is more commonly known as the shin. It expands at its proximal and distal ends; articulating at the knee and ankle joints respectively. The tibia is the second largest bone in the body and it is a key weight- bearing structure. 1. Proximal The proximal tibia is widened by the medial and lateral condyles, which aid in weight-bearing. The condyles form a flat surface, known as the tibial plateau. This structure articulates with the femoral condyles to form the key articulation of the knee joint. Located between the condyles is a region called the intercondylar eminence – this projects upwards on either side as the medial and lateral intercondylar tubercles. This area is the main site of attachment for the ligaments and the menisci of the knee joint. Shaft The shaft of the tibia is prism-shaped, with three borders and three surfaces; anterior, posterior and lateral. For brevity, only the anatomically and clinically important borders/surfaces are mentioned here. 1. Anterior border – palpable subcutaneously down the anterior surface of the leg as the shin. The proximal aspect of the anterior border is marked by the tibial tuberosity; the attachment site for the patella ligament. 2. Posterior surface – marked by a ridge of bone known as soleal line. This line is the site of origin for part of the soleus muscle, and extends inferomedially, eventually blending with the medial border of the tibia. 3. Lateral border – also known as the interosseous border. It gives attachment to the interosseous membrane that binds the tibia and the fibula together. Distal The distal end of the tibia widens to assist with weight-bearing. The medial malleolus is a bony projection continuing inferiorly on the medial aspect of the tibia. It articulates with the tarsal bones to form part of the ankle joint. On the posterior surface of the tibia, there is a groove through which the tendon of tibialis posterior passes. Laterally is the fibular notch, where the fibula is bound to the tibia – forming the distal tibiofibular The Fibula The fibula is a bone located within the lateral aspect of the leg. Its main function is to act as an attachment for muscles, and not as a weight-bearer. It has three main articulations: 1. Proximal tibiofibular joint – articulates with the lateral condyle of the tibia. 2. Distal tibiofibular joint – articulates with the fibular notch of the tibia. 3. Ankle joint – articulates with the talus bone of the foot. Bony Landmarks 1. Proximal At the proximal end, the fibula has an enlarged head, which contains a facet for articulation with the lateral condyle of the tibia. On the posterior and lateral surface of the fibular neck, the common fibular nerve can be found. Bony Landmarks 1. Proximal At the proximal end, the fibula has an enlarged head, which contains a facet for articulation with the lateral condyle of the tibia. On the posterior and lateral surface of the fibular neck, the common fibular nerve can be found. 2. Shaft The fibular shaft has three surfaces – anterior, lateral and posterior. The leg is split into three compartments, and each surface faces its respective compartment e.g anterior surface faces the anterior compartment of the leg. 3. Distal Distally, the lateral surface continues inferiorly, and is called the lateral malleolus. The lateral malleolus is more prominent than the medial malleolus, and can be palpated at the ankle on the lateral side of the leg. The Patella The patella (kneecap) is located at the front of the knee joint, within the patellofemoral groove of the femur. Its superior aspect is attached to the quadriceps tendon and inferior aspect to the patellar ligament. It is classified as a sesamoid type bone due to its position within the quadriceps tendon, and is the largest sesamoid bone in the body. In this article we will look at the anatomy of the patella – its surface features, functions and clinical relevance. Bony Landmarks The patella has a triangular shape, with anterior and posterior surfaces. The apex of the patella is situated inferiorly and is connected to the tibial tuberosity by the patellar ligament. The base forms the superior aspect of the bone and provides Functions the attachment area for the The patella has two main functions: quadriceps tendon. The posterior surface of the 1. Leg extension – Enhances the patella articulates with the femur, leverage that the quadriceps tendon can and is marked by two facets: exert on the femur, increasing the 1. Medial facet – articulates with efficiency of the muscle. the medial condyle of the femur. 2. Protection – Protects the anterior 2. Lateral facet – aspect of the knee joint from physical articulates with the lateral trauma. condyle of the femur. Bones of the Foot The bones of the foot provide mechanical support for the soft tissues; helping the foot withstand the weight of the body whilst standing and in motion. They can be divided into three groups: Tarsals The tarsal bones of the foot are organised into three rows: proximal, intermediate, and distal. 1. Proximal Group The proximal tarsal bones are the talus and the calcaneus. These comprise the hindfoot, forming the bony framework around the proximal ankle and heel. Talus The talus is the most superior of the tarsal bones. It transmits the weight of the entire body to the foot. It has three articulations: Superiorly – ankle joint – between the talus and the bones of the leg (the tibia and fibula). Inferiorly – subtalar joint – between the talus and calcaneus. Anteriorly – talonavicular joint – between the talus and the navicular. The main function of the talus is to transmit forces from the tibia to the heel bone (known as the calcaneus). It is wider anteriorly compared to posteriorly which provides additional stability to the ankle.  Calcaneus The calcaneus is the largest tarsal bone and lies underneath the talus where it constitutes the heel. It has two articulations: Superiorly – subtalar (talocalcaneal) joint – between the calcaneus and the talus. Anteriorly – calcaneocuboid joint – between the calcaneus and the cuboid. It protrudes posteriorly and takes the weight of the body as the heel hits the ground when walking. The posterior aspect of the calcaneus is marked by calcaneal tuberosity, to which the Achilles tendon attaches. 2. Intermediate Group The intermediate row of tarsal bones contains one bone, the navicular (given its name because it is shaped like a boat). Positioned medially, it articulates with the talus posteriorly, all three cuneiform bones anteriorly, and the cuboid bone laterally. On the plantar surface of the navicular, there is a tuberosity for the attachment of part of the tibialis posterior tendon. 3. Distal Group In the distal row, there are four tarsal bones – the cuboid and the three cuneiforms. These bones articulate with the metatarsals of the foot The cuboid is furthest lateral, lying anterior to the calcaneus and behind the fourth and fifth metatarsals. As its name suggests, it is cuboidal in shape. The inferior (plantar) surface of the cuboid is marked by a groove for the tendon of fibularis longus. The three cuneiforms (lateral, intermediate (or middle) and medial) are wedge shaped bones. They articulate with the navicular posteriorly, and the metatarsals anteriorly. The shape of the bones helps form a transverse arch across the foot. They are also the attachment point for several muscles: Medial cuneiform – tibialis anterior, (part of) tibialis posterior, and fibularis longus Lateral cuneiform – flexor hallucis brevis Metatarsals Phalanges The metatarsals are located in The phalanges are the bones of the the forefoot, between the tarsals and toes. The second to fifth toes all phalanges. They are numbered I-V have proximal, middle, and distal (medial to lateral). phalanges. The great toe has only Each metatarsal has a similar structure. 2; proximal and distal phalanges. They are convex dorsally and consist of a head, neck, shaft, and base (distal They are similar in structure to the to proximal). metatarsals, each phalanx consists They have three or four articulations: of a base, shaft, and head. Proximally – tarsometatarsal joints – between the metatarsal bases and the tarsal bones. Laterally – intermetatarsal joint(s) – between the metatarsal and the adjacent metatarsals. Distally – metatarsophalangeal joint – between the metatarsal head and the proximal phalanx. Bone tuberculosis Tuberculosis is a severe infectious disease that usually affects your lungs. When it spreads to your bones, it's known as skeletal tuberculosis. Tuberculosis is an airborne disease caused by a very infectious bacterium called Mycobacterium tuberculosis. It can travel through the blood to the lymph nodes and bones as well as the spine and joints. Its Types: 1. Pulmonary tuberculosis, which mainly involves your lungs. The infection can cause chest pain, trouble breathing, and lung problems. 2. Extrapulmonary tuberculosis, when tuberculosis affects areas of the body other than your lungs. This is more often seen in people who have weakened immune systems because Symptoms of Bone Tuberculosis They may include:  Severe back pain  ‌Inflammation in back or joints  ‌Stiffness  Trouble moving or walking, especially in children  ‌Spinal abscess  ‌Soft tissue swelling  ‌Neurological disorders  ‌Tuberculosis-related meningitis  ‌Muscle weakness Diagnosis 1. Bacterial culture. If you have bone tuberculosis, you probably have an underlying lung infection. Your doctor may take a blood or sputum sample 2. Biopsy. which involves taking part of infected tissue and checking it for infection 3. Body fluid test. drawing pleural fluid which surrounds and protects your lungs, to check for infection. Or they may take cerebrospinal fluid from around your spinal cord 4. Polymerase chain reaction (PCR) test. This test boosts the genetic material of the mycobacterium and helps look for infection from small amounts of fluids.‌ 5. Immunological tests. to check for antibodies against tuberculosis or, in some cases, AIDS. 6. Radiological tests. If you have symptoms like bone deformities, you may need an X-ray, CT scan, or MRI. Treatment 1. Anti-tuberculosis drugs. Rifampicin, streptomycin, kanamycin, isoniazid, protionamide, cycloserine, and pyrazinamide are the most common anti-tuberculosis drugs. 2. Corticosteroids. These medications may be prescribed to prevent complications such as inflammation around your spinal cord or heart.‌ 3. Surgery. If you have advanced bone tuberculosis, Thanks!