Department of Orthopaedics, All India Institute of Medical Sciences, Hyderabad, Telangana, India.
Int J Mycobacteriol. 2023 Jan-Mar;12(1):100-102. doi: 10.4103/ijmy.ijmy_201_22.
Tubercular tenosynovitis of the wrist with carpal tunnel syndrome (CTS) is a rare occurrence. The authors present a case of tubercular flexor tenosynovitis of the wrist with CTS. A 60-year-old female presented with complaints of swelling in the volar aspect of the right wrist with numbness of the first three fingers for the past 6 months. Clinical and radiological diagnosis of chronic flexor tenosynovitis with median nerve compression neuropathy was made. The patient was operated with carpal tunnel release and total tenosynovectomy. Histopathology showed features suggestive of Koch's etiology. The patient was started with antitubercular therapy (ATT) and followed up regularly. Carpal tunnel symptoms subsided immediately after surgery and there was no recurrence of swelling at the last follow-up. Carpal tunnel release and tenosynovectomy should be performed at the earliest possible and followed up with ATT for better outcomes in tubercular tenosynovitis of the wrist with CTS.
腕结核性腱鞘炎伴腕管综合征(CTS)较为罕见。作者报告了一例伴 CTS 的腕结核性屈肌腱鞘炎。一名 60 岁女性因过去 6 个月右手腕掌侧肿胀伴前三个手指麻木而就诊。临床和影像学诊断为慢性屈肌腱鞘炎伴正中神经压迫性神经病。患者接受了腕管松解和全肌腱鞘切除术。组织病理学显示符合 Koch 病因的特征。患者开始接受抗结核治疗(ATT)并定期随访。腕管症状在手术后立即缓解,最后一次随访时无肿胀复发。对于伴 CTS 的腕结核性腱鞘炎,应尽早进行腕管松解和肌腱鞘切除术,并辅以 ATT,以获得更好的效果。