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腕部结核性腱鞘炎:一例罕见病例报告

Tuberculous Tenosynovitis of the Wrist: A Rare Case Report.

作者信息

Chahal Jashandeep Singh, Gupta Palak, Aggarwal Nipun, Gupta Aniket, Vats Amanpreet

机构信息

Department of Orthopaedics, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Ambala, Haryana, India.

Department of Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Ambala, Haryana, India.

出版信息

J Orthop Case Rep. 2024 Dec;14(12):102-105. doi: 10.13107/jocr.2024.v14.i12.5036.

Abstract

INTRODUCTION

Tuberculosis (TB) of the wrist joint is a rare presentation of extrapulmonary TB, accounting for about 1% of musculoskeletal TB cases. We present a case of wrist joint TB in a 15-year-old immunocompetent male patient.

CASE REPORT

A 15-year-old boy presented with 6-month history of left wrist swelling and pain along with constitutional symptoms for 2 months. Examination showed swelling, tenderness, and reduced range of wrist motion. Investigations revealed elevated inflammatory markers, lytic lesions on wrist X-ray, and positive polymerase chain reaction ( ) for Mycobacterium tuberculosis in synovial fluid. Histopathology of synovial biopsy demonstrated caseating granulomas, confirming the diagnosis- treatment with 6 months of anti-tubercular therapy led to complete resolution.

CONCLUSION

Though rare, wrist joint TB should be a diagnostic consideration in patients with chronic wrist symptoms. A high index of suspicion and early diagnosis using microbiological, radiological, and histopathological investigations prevents morbidity.

摘要

引言

腕关节结核是肺外结核的一种罕见表现,约占肌肉骨骼结核病例的1%。我们报告一例15岁免疫功能正常男性患者的腕关节结核病例。

病例报告

一名15岁男孩,有6个月的左腕肿胀和疼痛病史,并伴有2个月的全身症状。检查发现腕部肿胀、压痛,腕关节活动范围减小。检查显示炎症标志物升高,腕部X线出现溶骨性病变,滑液结核分枝杆菌聚合酶链反应( )呈阳性。滑膜活检的组织病理学显示干酪样肉芽肿,确诊后接受6个月的抗结核治疗,症状完全缓解。

结论

尽管腕关节结核罕见,但对于有慢性腕部症状的患者应考虑其诊断。高度怀疑并通过微生物学、放射学和组织病理学检查进行早期诊断可预防发病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc1f/11632519/508560b3ebc6/JOCR-14-102-g001.jpg

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