Tuberculous Tenosynovitis Presenting as Ganglion of Wrist

Tuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. A 57 years old male presented with swelling over the left wrist since 3 years Three swellings over dorsal aspect of the left wrist S...

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Main Authors:	Chavan, Shahaji, Sable, Shyamsunder Shambhu, Tekade, Sachin, Punia, Prashant
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2012
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540643/

id	pubmed-3540643
recordtype	oai_dc
spelling	pubmed-35406432013-01-14 Tuberculous Tenosynovitis Presenting as Ganglion of Wrist Chavan, Shahaji Sable, Shyamsunder Shambhu Tekade, Sachin Punia, Prashant Case Report Tuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. A 57 years old male presented with swelling over the left wrist since 3 years Three swellings over dorsal aspect of the left wrist Soft in consistency Non tender Non compressible Mobile at right angles to the plane of the wrist joint. ESR: 45 mm in 1 hr and rest blood investigations were normal. Ultrsonography showed giant cell tumor of Extensor Digitorum sheath. X-ray: soft tissue swelling and MRI was suggestive of extensor tendon sheath extraskeletal synovial Koch's, or giant cell tumor of tendon sheath. Excision of swelling was planned and intraoperatively, rice bodies were seen inside it. Histopathological examination showed caseous necrosis with granuloma formation. Patient was put on DOT1 therapy. Tuberculous tenosynovitis was first described by Acrel in 1777. Rice bodies occurring in joints affected by tuberculosis were first described in 1895 by Reise. Rice bodies will be diagnosed on plain radiographs when mineralization occurs. More than 50% of cases recur within 1 year of treatment. The currently recommended 6-month course is often adequate with extensive curettage lavage and synovectomy should be performed. Surgery is essential, but the extent of surgical debridement is still debatable. The surgeon has to be aware of the significance of loose bodies when performing routine excision of innocuous looking wrist ganglia. Hindawi Publishing Corporation 2012 2012-12-24 /pmc/articles/PMC3540643/ /pubmed/23320240 http://dx.doi.org/10.1155/2012/143921 Text en Copyright © 2012 Shahaji Chavan et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Chavan, Shahaji Sable, Shyamsunder Shambhu Tekade, Sachin Punia, Prashant
spellingShingle	Chavan, Shahaji Sable, Shyamsunder Shambhu Tekade, Sachin Punia, Prashant Tuberculous Tenosynovitis Presenting as Ganglion of Wrist
author_facet	Chavan, Shahaji Sable, Shyamsunder Shambhu Tekade, Sachin Punia, Prashant
author_sort	Chavan, Shahaji
title	Tuberculous Tenosynovitis Presenting as Ganglion of Wrist
title_short	Tuberculous Tenosynovitis Presenting as Ganglion of Wrist
title_full	Tuberculous Tenosynovitis Presenting as Ganglion of Wrist
title_fullStr	Tuberculous Tenosynovitis Presenting as Ganglion of Wrist
title_full_unstemmed	Tuberculous Tenosynovitis Presenting as Ganglion of Wrist
title_sort	tuberculous tenosynovitis presenting as ganglion of wrist
description	Tuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. A 57 years old male presented with swelling over the left wrist since 3 years Three swellings over dorsal aspect of the left wrist Soft in consistency Non tender Non compressible Mobile at right angles to the plane of the wrist joint. ESR: 45 mm in 1 hr and rest blood investigations were normal. Ultrsonography showed giant cell tumor of Extensor Digitorum sheath. X-ray: soft tissue swelling and MRI was suggestive of extensor tendon sheath extraskeletal synovial Koch's, or giant cell tumor of tendon sheath. Excision of swelling was planned and intraoperatively, rice bodies were seen inside it. Histopathological examination showed caseous necrosis with granuloma formation. Patient was put on DOT1 therapy. Tuberculous tenosynovitis was first described by Acrel in 1777. Rice bodies occurring in joints affected by tuberculosis were first described in 1895 by Reise. Rice bodies will be diagnosed on plain radiographs when mineralization occurs. More than 50% of cases recur within 1 year of treatment. The currently recommended 6-month course is often adequate with extensive curettage lavage and synovectomy should be performed. Surgery is essential, but the extent of surgical debridement is still debatable. The surgeon has to be aware of the significance of loose bodies when performing routine excision of innocuous looking wrist ganglia.
publisher	Hindawi Publishing Corporation
publishDate	2012
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540643/
_version_	1611945517943619584

Tuberculous Tenosynovitis Presenting as Ganglion of Wrist

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