TUBERCULOUS TENOSYNOVITIS OF FLEXOR TENDON PRESENTING AS MASS ON THE PALMAR ASPECT OF RIGHT RING FINGER: A RARE CASE REPORT

Infectious tuberculous tenosynovitis is an exceptional location of musculoskeletal tuberculosis involving exor tendon of the nger. The patient was a 38 year old female of tuberculous exor tendon presenting as a mass on the palmar aspect of the right hand & ring nger without any other pulmonary or extrapulmonary tubercular manifestation. This report highlights the occurrence of tuberculous tenosynovitis in our environment in patients with associated risk factors for early diagnosis and treatment.

Tuberculosis tenosynovitis of the wrist: a rare case report

Tuberculosis (TB) is a common disease of the Asian continent and has a varied presentation. Involvement of the musculoskeletal system is uncommon and presents in 10% of extrapulmonary tuberculosis. The atypical sites of tuberculous infection are the spine (51%) pelvis (12%), hip and femur (10%), knee and tibia (10%), and ribs (7%), but involvement of the wrist is rare. Tuberculosis tenosynovitis is a rare site of extra-articular TB. Delayed diagnosis and hence treatment is because it mimics many other disease processes and as a result, complications are common. Median nerve compression leading to carpal tunnel syndrome may also occur in these patients. Here, we present a case of tuberculous tenosynovitis involving the wrist flexors and the radial and ulnar bursae treated with surgery.

Tuberculous Tenosynovitis of the Wrist: A Report of Two Cases with Special Reference to Magnetic Resonance Findings

Background: Tuberculous tenosynovitis of the wrist is rare among cases of musculoskeletal tuberculosis. It is a slow, progressive disease with silent symptoms, leading to a late diagnosis. Also, it can be misdiagnosed as inflammatory arthritis, pyogenic infections, and inflammatory tenosynovitis. Thus, patients present with destructive changes of the bone and joint, as well as abscesses, often receive incorrect or unnecessary medical and surgical treatment. Discussion: Well-documented anamneses along with physical examinations and radiologic imaging methods, such as computed tomography (CT) and magnetic resonance imaging (MRI), can be useful in the diagnosis of tuberculous tenosynovitis. All chronic synovitis of the wrist with longstanding pain should be considered as mycobacterial infection and an important differential diagnosis. Early diagnosis followed by extensive debridement and antituberculous chemotherapy provides good functional results. Conclusion: This article presents the cases of two patients with wrist tuberculous tenosynovitis and the respective MRI findings. It also includes a literature review.