Case Report: Multiple Tuberculous Tenosynovitis of the Flexor Tendons of the Wrist and Hand

Background: Tuberculosis is a significant public health challenge and tuberculous tenosynovitis is therefore a rare form of musculoskeletal tuberculosis which usually affects the flexor tendons of the hand and wrist. Case presentation: We present a case of a 63-year-old male. He presented multiple progressively enlarging mass over the volar side of the right hand and wrist. He did not have a previous history of tuberculosis. However, his erythrocyte sedimentation rate was high and tuberculosis antibody test was slightly positive. Radiograph of chest showing multiple nodular and patchy dense shadows in bilateral lungs, and localized soft tissue mass around the radiocarpal joint. Excision biopsy of the mass was done and samples sent for histopathology comment. The findings were an inflamed, thickened synovia: suggestive of tuberculous tenosynovitis. Anti-tuberculous chemotherapy was commenced on the second postoperative day. Conclusion: Tuberculous tenosynovitis of the wrist is rare. However, in developing area where tuberculosis is prevalent, it should be part of the differential diagnosis of compound palmar ganglion in order to prevent delayed diagnosis and treatment.