Tubercular Tenosynovitis of Extensor Tendons of Ankle : A Case Report

India being an endemic region for Tuberculosis (TB) has a high incidence of musculoskeletal TB with various presentations. Tenosynovitis is a rare presentation and few cases have been reported involving the hand and wrist but isolated involvement of extensor tendons at the ankle is even rarer and unreported.

Thirty-five-year-old female patient presenting with a dumbbell-shaped swelling over the anterolateral aspect of right ankle with mild dull aching pain. MRI revealed altered signal intensities surrounding the extensor tendons at the ankle without the involvement of the joint. Surgical debridement was done and six-month ATT was given. Gross specimen revealed rice bodies and histopathological examination showed caseous necrosis and epitheloid cell granulomas.

Tuberculosis TB being endemic can have varied presentations, early diagnosis can be made if clinical suspicion for TB is considered. ATT is the mainstay of treatment, but surgical debridement is necessary for extensive lesions with compressive symptoms.