Tuberculous tenosynovitis and bursitis: imaging findings in 21 cases.
OBJECTIVE
To describe imaging features of tuberculous tenosynovitis and bursitis with various imaging methods.


METHODS
Twenty-one patients with surgically and/or pathologically proved tuberculosis of the tendon sheaths or bursae were evaluated. Routine radiography, arthrography, computed tomography (CT), and magnetic resonance (MR) imaging were used in some or all of the patients.


RESULTS
Twelve patients had tuberculous tenosynovitis, and nine had bursitis. Tuberculous tenosynovitis most commonly involved the tendon sheaths of the hand and wrist, whereas bursitis occurred most frequently about the hip, especially in the trochanteric bursa. All cases of tuberculous tenosynovitis or bursitis showed soft-tissue swelling on plain radiographs, with calcification demonstrated in three of nine (33%) cases. CT and MR imaging allowed evaluation of all forms of tuberculous tenosynovitis (hygromatous, serofibrinous, and fungoid forms), whereas tuberculous bursitis exhibited two patterns of involvement: either a distended bursa or multiple small abscesses. Contrast material-enhanced radiography (i.e., arthrography) helped delineate communication between the affected structures.


CONCLUSIONS
All imaging methods can provide complementary information that is helpful for determination of therapy. MR imaging seems to be superior in evaluating the extent of the lesion, particularly in soft tissue.
Department of Radiology, Veterans Affairs Medical Center, San Diego, CA 92161, USA.
S
S
Jaovisidha
C
C
Chen
K N
KN
Ryu
P
P
Siriwongpairat
P
P
Pekanan
D J
DJ
Sartoris
D
D
Resnick
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013717:Tenosynovitis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014394:Tuberculosis, Osteoarticular / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging