Bagir Melih, Sayit Emrah
Department of Orthopaedics and Traumatology, Samsun Education and Research Hospital, Samsun, Turkey.
Curr Med Imaging Rev. 2019;15(5):517-520. doi: 10.2174/1573405614666180919141141.
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.
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.
This article presents the cases of two patients with wrist tuberculous tenosynovitis and the respective MRI findings. It also includes a literature review.
腕关节结核性腱鞘炎在肌肉骨骼结核病例中较为罕见。它是一种进展缓慢、症状隐匿的疾病，导致诊断延迟。此外，它可能被误诊为炎性关节炎、化脓性感染和炎性腱鞘炎。因此，出现骨与关节破坏以及脓肿的患者常常接受不正确或不必要的药物及手术治疗。
详细的病史、体格检查以及放射影像学方法，如计算机断层扫描（CT）和磁共振成像（MRI），对结核性腱鞘炎的诊断可能有用。所有伴有长期疼痛的腕关节慢性滑膜炎都应被视为分枝杆菌感染并作为重要的鉴别诊断。早期诊断后进行广泛清创和抗结核化疗可取得良好的功能结果。
本文介绍了两名腕关节结核性腱鞘炎患者的病例及各自的MRI表现。还包括一篇文献综述。
