Radiological Overview of Tubercular Arthritis of Wrist Joint: A Case Report

Abstract

Musculoskeletal Tuberculosis (TB) worldwide with wrist involvement is very rare. Maximum cases of tuberculous arthritis arise in patients born in and migrated from endemic regions, particularly in patients who are co-infected with Human Immunodeficiency Virus (HIV). Authors present a rare case of tuberculous arthritis of the wrist joint in a 64-year-old male having pain, swelling, and decreased range of motion in the left wrist for six months. X-ray and Computed Tomography (CT) showed erosion of carpal bones, reduced joint space, and soft tissue oedema and abscess. On Ultrasonography (USG) joint effusion and soft tissue oedema, were seen around the wrist joint, and on Magnetic Resonance Imaging (MRI) along with this marrow oedema were also noted. Aspirated fluid culture from abscess suggested Mycobacterium positive culture and Ziehl–Neelsen (Z-N) staining showed acid-fast bacilli. Antitubercular therapy was the mainstay of treatment. A high level of suspicion should be kept for TB in every infection of the wrist joint.

Keywords

• acid-fast bacilli
• antitubercular therapy
• magnetic resonance imaging