Palma José, Díaz Eduardo, Islas Sergio, Silva Julio, Mella Sergio
Hospital Traumatológico de Concepción, Concepción, Chile.
Rev Chilena Infectol. 2017 Oct;34(5):511-515. doi: 10.4067/S0716-10182017000500511.
Monoarticular tuberculosis of the wrist is a rare presentation of primary tuberculosis, being more common skeletal forms involving the spine. Extraspinal tuberculous osteomyelitis is rare and comprises only 2 to 3% of all cases of osteoarticular Mycobacterium tuberculosis infections. We present a case of a 49 years old female patient, who worked as an hospital cleaning employed without other comorbidity. After a low energy injury of the wrist she suffered pain syndrome diagnosticated as a flexor tendinopathy, managed with nonsteroidal antiinflammatory drugs and physical therapy. Eight months later patient evolves with chronic pain in range of motion of right wrist joint, leading to a complete radiological, surgical biopsy and cultures. Histology, and molecular biology confirmed the wrist joint tuberculosis diagnosis. Pharmacological treatment and physical therapy were initiated with appropriated response.
腕关节单关节结核是原发性结核的一种罕见表现，在骨骼结核中，脊柱受累更为常见。脊柱外结核性骨髓炎较为罕见，仅占骨关节结核分枝杆菌感染所有病例的2%至3%。我们报告一例49岁女性患者，她是一名医院清洁工，无其他合并症。腕部低能量损伤后，她出现疼痛综合征，诊断为屈肌腱病，采用非甾体抗炎药和物理治疗。八个月后，患者右腕关节活动时出现慢性疼痛，随后进行了全面的影像学检查、手术活检和培养。组织学和分子生物学检查证实了腕关节结核的诊断。开始进行药物治疗和物理治疗，反应良好。
