Tuberculous Tenosynovitis of the Wrist: A Rare Case Report

Tuberculosis (TB) of the wrist joint is a rare presentation of extrapulmonary TB, accounting for about 1% of musculoskeletal TB cases. We present a case of wrist joint TB in a 15-year-old immunocompetent male patient.

A 15-year-old boy presented with 6-month history of left wrist swelling and pain along with constitutional symptoms for 2 months. Examination showed swelling, tenderness, and reduced range of wrist motion. Investigations revealed elevated inflammatory markers, lytic lesions on wrist X-ray, and positive polymerase chain reaction ( ) for Mycobacterium tuberculosis in synovial fluid. Histopathology of synovial biopsy demonstrated caseating granulomas, confirming the diagnosis- treatment with 6 months of anti-tubercular therapy led to complete resolution.

Though rare, wrist joint TB should be a diagnostic consideration in patients with chronic wrist symptoms. A high index of suspicion and early diagnosis using microbiological, radiological, and histopathological investigations prevents morbidity.