Tuberculous Tenosynovitis of the Wrist: A Report of Two Cases with Special Reference to Magnetic Resonance Findings

Abstract

Background: Tuberculous tenosynovitis of the wrist is rare among cases of musculoskeletal tuberculosis. It is a slow, progressive disease with silent symptoms, leading to a late diagnosis. Also, it can be misdiagnosed as inflammatory arthritis, pyogenic infections, and inflammatory tenosynovitis. Thus, patients present with destructive changes of the bone and joint, as well as abscesses, often receive incorrect or unnecessary medical and surgical treatment. Discussion: Well-documented anamneses along with physical examinations and radiologic imaging methods, such as computed tomography (CT) and magnetic resonance imaging (MRI), can be useful in the diagnosis of tuberculous tenosynovitis. All chronic synovitis of the wrist with longstanding pain should be considered as mycobacterial infection and an important differential diagnosis. Early diagnosis followed by extensive debridement and antituberculous chemotherapy provides good functional results. Conclusion: This article presents the cases of two patients with wrist tuberculous tenosynovitis and the respective MRI findings. It also includes a literature review.