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Related Experiment Videos

Tuberculosis presenting as carpal tunnel syndrome.

K E Lee

    The Journal of Hand Surgery
    |March 1, 1985
    PubMed
    Summary

    Tuberculosis can cause carpal tunnel syndrome. Early diagnosis via tissue analysis and treatment with surgery and chemotherapy are crucial for managing this rare presentation of Mycobacterium tuberculosis.

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    Area of Science:

    • Infectious Diseases
    • Orthopedic Surgery
    • Rheumatology

    Background:

    • Carpal tunnel syndrome (CTS) is a common condition often diagnosed based on clinical presentation and electrodiagnostic studies.
    • Unexplained chronic synovitis in the wrist can present diagnostic challenges.
    • The differential diagnosis for CTS typically includes inflammatory and mechanical causes.

    Observation:

    • A 44-year-old male presented with classic symptoms and signs of carpal tunnel syndrome.
    • During surgical excision of the flexor tenosynovium, Mycobacterium tuberculosis was identified.
    • The patient exhibited unexplained chronic synovitis of the wrist.

    Findings:

    • Mycobacterium tuberculosis infection of the tenosynovium can mimic idiopathic carpal tunnel syndrome.
    • Acid-fast staining and tissue culture are essential for diagnosing tuberculous tenosynovitis.
    • Prompt diagnosis is critical as the condition may be overlooked with standard CTS evaluations.

    Implications:

    • Tuberculosis should be included in the differential diagnosis for patients with carpal tunnel syndrome and unexplained chronic synovitis.
    • Diagnostic strategies for recalcitrant CTS should consider infectious etiologies, particularly tuberculosis.
    • Effective management involves surgical synovectomy, early mobilization, and appropriate anti-tuberculosis chemotherapy.

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