Miquel A, Frouge C, Adrien C, Hibou I, Bittoun J, Bisson M, Bléry M
Service de Radiologie Centrale, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
J Radiol. 1995 May;76(5):285-8.
Chronic tenosynovitis of the hand due to Mycobacterium tuberculosis has become rare. In the two cases presented here, the final diagnosis was obtained by isolation of the organism in the intercarpal fluid (1 case), or by a synovial biopsy (1 case). Ultrasonography showed a hypoechoic thickening of one or several tendon sheaths. MR enabled better differentiation between the thickening of the synovium itself and a fluid effusion. The criteria permitting to differentiate tuberculous from non-infectious tenosynovitis are: young age, male sex, specific epidemiological factors, elevated erythrocyte sedimentation rate, marked local swelling, association with other foci of tuberculosis, unusual exudation and synovial thickening, and association with osteitis.
由结核分枝杆菌引起的手部慢性腱鞘炎已较为罕见。在此呈现的两例病例中,最终诊断是通过从腕间液中分离出病原体(1例)或通过滑膜活检(1例)得以明确的。超声检查显示一个或多个腱鞘低回声增厚。磁共振成像能更好地区分滑膜本身的增厚与积液。可用于区分结核性与非感染性腱鞘炎的标准包括:年轻、男性、特定的流行病学因素、红细胞沉降率升高、明显的局部肿胀、与其他结核病灶相关、异常渗出和滑膜增厚以及与骨炎相关。