Tubercular Tenosynovitis of Hand: A Rare Presentation.
BACKGROUND
Tuberculosis tenosynovitis of the wrist and hand is an unusual condition. It mimics a number of other clinical conditions such as ganglion, De quervan's disease, carpal tunnel syndrome, granulomatous gout, neurofibroma, and haemangioma.


METHODS
We present case of 58-year-old male patient with swelling over thenar region of left hand where the initial fine needle aspiration cytology (FNAC) report suggested diagnosis of ganglion/synovial cyst, but the patient did not improve with conservative treatment. FNAC was repeated which showed granulomatous inflammation consistent with the clinical diagnosis of tuberculosis and antitubercular therapy for 9 months was given. Swelling disappeared and normal range of movements was attained in adjacent joints at final follow-up of 12 months from initiation of antitubercular treatment (ATT).


CONCLUSIONS
The literature on the management of tubercular tenosynovitis has mostly incorporated surgical method as one of the first-line treatments. We report an unusual case, where the tenosynovitis of wrist completely responded within 12 months of ATT without any need of surgical treatment.
Department of Orthopaedics, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
Aditya
A
Jain
Department of Orthopaedics, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
Rajesh
R
Rohilla
Department of Orthopaedics, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
Ashish
A
Devgan
Department of Orthopaedics, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
Jitendra
J
Wadhwani
ATT; Ganglion; Tenosynovitis; Tuberculosis