title: Tuberculous tenosynovitis: a cause of Carpal Tunnel Syndrome.
abstract: OBJECTIVE
  To highlight the presentation of tuberculous tenosynovitis as Carpal Tunnel Syndrome (CTS).
  
  
  METHODS
  A descriptive study conducted with purposive sampling on the patients presenting between April 2004 to January 2005 to the department of Plastic Surgery, CMH Rawalpindi, with the clinical picture of CTS. Symptoms and signs were recorded. The carpal tunnels were explored under nerve blocks. Where tenosynovitis was observed per-operatively, specimen of excised synovium were sent for histo-pathological examination, acid fast stains and bacterial cultures, to ascertain or rule out the presence of tuberculosis.
  
  
  RESULTS
  A total of 53 patients predominantly males were included in the study. The median age was 43 years and average duration of symptoms was 9 months. Tenosynovitis was observed in three patients (6%) per-operatively, with histopathology suggestive of Tuberculous tenosynovitis. Point Prevalence of tuberculous tenosynovitis as a cause of CTS was 6%. These patients reported clinical improvement with anti-tuberculosis treatment. NCS/EMG co-related well with clinical relief.
  
  
  CONCLUSIONS
  Tuberculous tenosynovitis is an uncommon cause of median nerve compression at the wrist. As symptoms are usually typical of CTS, diagnosis is frequently missed. Consideration of the possibility, examination of the opened canal at surgery and proper treatment can result in a successful outcome.
authors.affiliation: Department of Plastic Surgery, Combined Military Hospital, Rawalpindi.
authors.forename: Mamoon
authors.initials: M
authors.lastname: Rashid
authors.forename: Saad Ur Rehman
authors.initials: SU
authors.lastname: Sarwar
authors.forename: Ehtesham Ul
authors.initials: EU
authors.lastname: Haq
authors.forename: Muhammad Zia Ul
authors.initials: MZ
authors.lastname: Islam
authors.forename: Taokeer Ahmad
authors.initials: TA
authors.lastname: Rizvi
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ahmad
authors.forename: Kokab
authors.initials: K
authors.lastname: Shah
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013717:Tenosynovitis / Q000382:microbiology*; D014394:Tuberculosis, Osteoarticular / Q000150:complications*