Tuberculosis tenosynovitis with multiple rice bodies of the flexor tendons in the wrist: A case report

• Therefore, although a rare diagnosis, tuberculosis of the tendon sheath should be kept in mind in developing countries. The reason is that the presentation and lab findings of tendon sheath tuberculosis are non-specific, making it hard to differentiate from other causes for this condition. For example a wrist tuberculosis may present with carpal tunnel symptoms. While MR sequences, especially T2, may give hints of tuberculosis, these can be easily misinterpreted as pigmented villonodular synovitis.
• All these may cause a delay in diagnosis. In order to prevent any delay in diagnostic evaluation, all steps should be taken carefully.
• Wide debridements to alleviate the symptoms of wrist tuberculosis is not enough a treatment. It is true that wide debridements quickly lessens the symptoms; however, the actual treatment of the condition is antituberculosis treatment directed at the causative organism. Antituberculosis medications are needed to decrease recurrence levels and avoid complications.

IntroductionOne of the infectious causes of wrist tenosynovitis is Mycobacterium tuberculosis. Tendon sheath involvement is rare. Herein, we report the diagnosis and treatment of a patient with neglected wrist flexor tendon sheath tuberculosis.Presentation of caseWe report the diagnosis and treatment of a man aged 50 years with neglected wrist flexor tendon sheath tuberculosis.DiscussionIn patients with tendon sheath involvement, symptoms are generally non-specific such as pain and swelling; therefore, it can be diagnosed late due to the lack of systemic symptoms. Wrist X-ray imaging in tenosynovitis may show soft tissue swelling and osteoporotic changes around the wrist joint. T2-weighted sequences in magnetic resonance imaging are more successful in supporting the diagnosis.ConclusionM. tuberculosis should be kept in mind as an infectious agent, especially in developing countries. In order to prevent any delay in diagnostic evaluation, all steps should be taken carefully.