A RARE PRESENTATION OF MUSCULOSKELETAL TUBERCULOSIS: TENOSYNOVITIS OF THE FLEXOR TENDONS OF THE WRIST AND DIGITS

Abstract

One of the extrapulmonary mycobacterium tuberculosis infection is wrist tenosynovitis and treatment of the wrist tenosynovitis includes antibiotics and surgical debridement. We report the diagnosis and treatment of a patient with tuberculosis tenosynovitis of the flexor tendons of the wrist and digits. Our patient was 65 years old. In his physical examination, swelling, redness, and warming along the wrist and draining open wounds on the palmar surfaces of the first and fifth fingers at the same hand were detected. In the laboratory tests, his acute-phase reactants had increased and in the T2A series, MRI findings depicted millimetric nodular images on the sheath of the flexor tendons of the wrist and first and fifth digits, which were consistent with synovitis. Debridement and synovectomy of flexor tendons of the wrist and D1, D5 of the left side was performed. A total of 6 months of a rifampicin-based anti-tuberculosis treatment was administered. In the second year after the operation, there was no problem with previous wound, and range of motion and muscle strength of the fingers and wrist joint were complete.