Tuberculosis tenosynovitis with multiple rice bodies of the flexor tendons in the wrist: A case report

INTRODUCTION: One of the infectious causes of wrist tenosynovitis is Mycobacterium tuberculosis. Tendon sheath involvement is rare. Herein, we report the diagnosis and treatment of a patient with neglected wrist flexor tendon sheath tuberculosis. PRESENTATION OF CASE: We report the diagnosis and treatment of a man aged 50 years with neglected wrist flexor tendon sheath tuberculosis. DISCUSSION: In patients with tendon sheath involvement, symptoms are generally non-specific such as pain and swelling; therefore, it can be diagnosed late due to the lack of systemic symptoms. Wrist X-ray imaging in tenosynovitis may show soft tissue swelling and osteoporotic changes around the wrist joint. T2-weighted sequences in magnetic resonance imaging are more successful in supporting the diagnosis. CONCLUSION: M. tuberculosis should be kept in mind as an infectious agent, especially in developing countries. In order to prevent any delay in diagnostic evaluation, all steps should be taken carefully.