Tuberculosis: A Silent Intruder in the Musculoskeletal Landscape of the Upper Extremity

Tuberculosis (TB) is an infection that can occur in every organ of the body, including the musculoskeletal system. Musculoskeletal involvement in TB can be missed because of its non-specific clinical signs. The disease may mimic inflammatory arthritis, and high clinical suspicion is required when dealing with longstanding swelling of soft tissues, bones, or joints. This is a case series consisting of four patients diagnosed with TB of the musculoskeletal system of the upper extremity and treated with anti-TB drugs over a period of three years. The aim was to analyze the usual presentation pattern, time delay in diagnosis, the key diagnostic tool, and mainstay treatment of choice. All four patients were treated with a regimen of a combination of anti-TB drugs, initial splinting, and intensive physiotherapy for functional rehabilitation and had complete resolution of pain and infection. The operative treatment was usually limited and mainly included debridement along with biopsy for definitive diagnosis. The mainstay treatment had been appropriate drug therapy. Musculoskeletal TB can be treated effectively with anti-TB drugs. Confirmation of the diagnosis with biopsy is vital in prompt initiation of the appropriate treatment, which can lead to better outcomes in patients.