Tuberculosis of the wrist mimicking rheumatoid arthritis - A rare case

Introduction Mycobacterium tuberculosis causes infection in approximately one-third of the world's population. Arthritis due to Mycobacteriurn tuberculosis usually presents as a chronic, slowly progressive, monoarticular infection that predominantly involves the weight-bearing joints and the spine. The hand and wrist are rare sites for tuberculosis (TB) and comprises of Presentation of case A 35 years old woman came with the chief complaint of pain and swelling on the right wrist since 1 year ago and was diagnosed with rheumatoid arthritis of the wrist. Patient then was given methylprednisolone 4 mg twice a day and methotrexate 175 mg once a week. However, the pain and swelling of her right wrist became worse. Subsequently patient was admitted to hospital and laboratory findings suggested a tuberculous arthritis of the wrist. Debridement, synovectomy, and biopsy, in addition to antituberculosis therapy, were then performed. Discussion Tuberculous arthritis is generally a monoarticular disease that typically involves the spine or large and medium-sized joints. Rheumatoid arthritis (RA) and tuberculous arthritis may have similar clinical characteristics, which consists of a chronic course with periarticular soft-tissue swelling. Conclusion Tuberculous arthritis and RA can have similar characteristic but laboratory examination can help in establishing diagnosis.