Basnayake Oshan, Nihaj Ahamed, Pitagampalage Ranji, Mendis Harsha
National Hospital of Sri Lanka, Colombo, Sri Lanka.
Case Rep Surg. 2019 Oct 17;2019:4916157. doi: 10.1155/2019/4916157. eCollection 2019.
Tuberculosis is a common disease entity in South East Asian countries with a significant global burden. An extra skeletal manifestation such as monoarticular TB is common, but isolated involvement of the wrist is rare.
A 53-year-old Sri Lankan male with long-standing diabetes presented with an isolated hand swelling for a 7-month duration. His initial imaging and MRI showed multiple destructive lesions in the carpal bones, surrounding focal fluid collections and found to have caseous material intraoperatively. His histology and microbiological studies were positive for TB with no other concurrent evidence of TB elsewhere.
Different presentations of tuberculosis should be considered when patients are presenting with atypical clinical and initial basic investigation findings in relation to monoarticular pathologies.
结核病在东南亚国家是一种常见疾病,给全球带来重大负担。诸如单关节结核这样的骨骼外表现很常见,但腕关节单独受累罕见。
一名53岁患有长期糖尿病的斯里兰卡男性,手部孤立性肿胀达7个月。其初始影像学检查和磁共振成像显示腕骨有多个破坏性病变,周围有局灶性液体积聚,术中发现有干酪样物质。他的组织学和微生物学检查结果显示结核呈阳性,身体其他部位无其他并发结核证据。
当患者出现与单关节病变相关的非典型临床和初始基础检查结果时,应考虑结核病的不同表现形式。