Tuberculous Tenosynovitis of the wrist: A rare presentation of extra-pulmonary tuberculosis and delays in diagnosis

Abstract

Tuberculous tenosynovitis, formerly known as compound palmar ganglion, is a rare condition that presents usually as chronic painless swelling, tenosynovitis, and sometimes with compressive neuropathy. Approximately 10% of all extrapulmonary manifestations of tuberculosis involve the musculoskeletal system and among them, involvement of the wrist and hand is a very rare condition. It is really important to manage this condition before it spreads to the underlying bones causing osteomyelitis and destruction. Here, we are going to report two cases both presenting with a painless swelling and restriction of movement of their wrists for more than 6 months. In physical examination, one of the patients had also numbness over median nerve territory. After imaging, biopsies, cultures, and histopathological examinations, wrist swelling was considered as tuberculous tenosynovitis and appropriate anti-tuberculosis treatment was started.

Keywords

• compound palmar ganglion
• extrapulmonary tuberculosis
• tuberculous tenosynovitis of the wrist