Title: Isolated Tenosynovitis of the Extensor Tendon Sheath of the Wrist Revealing a Rare Tuberculosis Localization: A Case Report
Authors: Kaoutar Maasaoui MD, Salma Abouchiba MD, Amina Hamdaoui MD, Nizar El Bouardi MD, Amal Akammar MD, Meryem Haloua MD, Badreeddine Alami MD, Moulay Youssef Alaoui Lamrani MD, Meryem Boubbou MD, Mustapha Maaroufi MD
Volume: 8
Issue: 7
Pages: 85-89
Publication Date: 2024/07/28
Abstract:
Tuberculosis (TB) is still a major public health problem in both developing and industrialized countries. Extrapulmonary manifestations are estimated to occur in approximately 20% of patients with TB.[1] and all accounts of musculoskeletal TB represent around 1-3% of tuberculous infections. Although diagnosis of extraspinal musculoskeletal TB is not possible based only on the clinical or imaging findings, the radiological aspect may guide further diagnostic workup and may result in earlier and adequate treatment. We report the case of a 14-year-old girl who presented with swelling on the dorsal aspect of the wrist. The wrist ultrasound indicated tenosynovitis accompanied by nodular thickening of the synovium, resembling pigmented villonodular synovitis. An MRI was conducted to exclude this diagnosis, revealing nodular thickening of the synovium, enhanced after contrast, suggesting a specific infection such as tuberculosis. Confirmation of the diagnosis was obtained through synovial fluid aspiration followed by PCR analysis. Musculoskeletal tuberculosis is an uncommon manifestation. Wrist tenosynovitis is exceedingly rare. Nevertheless, this diagnosis warrants consideration in cases of chronic, non-inflammatory tenosynovitis without any associated rheumatological context.