Tuberculous tenosynovitis of the flexor tendons of the wrist: a case report
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Date
2018-04
Journal Title
Journal ISSN
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Publisher
BMC Research Notes
Abstract
Background
Tuberculous tenosynovitis poses a significant public health challenge, especially in developing countries. It usually affects the flexor tendons of the wrist.
Case presentation
We present a case of a 65-year-old Ghanaian female. She presented a progressively enlarging mass over the volar aspect of the right wrist and palm. She did not have a previous history of tuberculosis. However, her erythrocyte sedimentation rate was high and Mantoux (purified protein derivative) test was strongly positive (more than 15 mm). Radiograph of ulna, radius, and wrist showed osteopenic changes around the distal radius. Excision biopsy of the mass was done and samples sent for histopathology comment. The findings were an inflamed, thickened synovia with rice bodies: suggestive of tuberculous tenosynovitis. Anti-tuberculous chemotherapy was commenced on the second postoperative day.
Conclusion
Tuberculous tenosynovitis of the wrist is uncommon. However, in developing countries like Ghana where tuberculosis is prevalent, it should be part of the differential diagnosis of compound palmar ganglion in order to prevent delayed diagnosis and treatment.
Description
Keywords
Compound palmar ganglion, Rice bodies, Melon bodies, And flexor tendon sheath