Marjolin's Ulcer Secondary to Tuberculous Tenosynovitis of the Wrist: A Case Report

Tuberculous tenosynovitis usually presents as a chronic, slowly progressive disease. It is difficult to detect in early phase and diagnosis frequently requires biopsy in addition to stain or culture. Authors describe a case who had a Marjolin's ulcer secondary to tuberculous tenosynovitis of the wrist.

Tuberculous Tenosynovitis of Flexor Tendon of the Hand

PURPOSE: The sheath of tendon is uncommon site of tuberculous involvement as compared to other parts of the body. Especially, tuberculous tenosynovitis affecting flexor tendon of the hand is a rare condition. In recent years, furthermore, the incidence of tuberculosis is increasing in our country. Tuberculous tenosynovitis is a chronic, slowly destructive disease, which is difficult to diagnosis before operation, but can be definitively diagnosed by the pathologic microscopic examination. Early detection and surgical excision combined with antituberculous medication is important. We report a rare case of tuberculous tenosynovitis of the flexor tendon of the hand. METHODS: A 12-year-old woman presented with a painless, nontender mass on palmar side between distal interphalangeal joint and proximal area of metacarpophalangeal joint of the left third finger. We had surgical excision of the involved flexor tendon sheath and studied histopathologically. RESULTS: The histopathological findings were chronic granulomatous inflammation with caseating necrosis consistent with tuberculosis. We started antituberculous medication. CONCLUSION: Tuberculous tenosynovitis is a rare condition, especially involving on the flexor tendon of the hand. But because of increasing tendency of tuberculosis, it is important to differentiate it from other tumors of the hand.

Tuberculous Tenosynovitis of Flexor Tendon of the Hand

PURPOSE: The sheath of tendon is uncommon site of tuberculous involvement as compared to other parts of the body. Especially, tuberculous tenosynovitis affecting flexor tendon of the hand is a rare condition. In recent years, furthermore, the incidence of tuberculosis is increasing in our country. Tuberculous tenosynovitis is a chronic, slowly destructive disease, which is difficult to diagnosis before operation, but can be definitively diagnosed by the pathologic microscopic examination. Early detection and surgical excision combined with antituberculous medication is important. We report a rare case of tuberculous tenosynovitis of the flexor tendon of the hand. METHODS: A 12-year-old woman presented with a painless, nontender mass on palmar side between distal interphalangeal joint and proximal area of metacarpophalangeal joint of the left third finger. We had surgical excision of the involved flexor tendon sheath and studied histopathologically. RESULTS: The histopathological findings were chronic granulomatous inflammation with caseating necrosis consistent with tuberculosis. We started antituberculous medication. CONCLUSION: Tuberculous tenosynovitis is a rare condition, especially involving on the flexor tendon of the hand. But because of increasing tendency of tuberculosis, it is important to differentiate it from other tumors of the hand.

NURSING AND REHABILITATION GUIDANCE OF TUBERCULOUS TENOSYNOVITIS / 现代医院

Objective To investigate feature on the diagnosis and treatment and care and recovery of tuberculous tenosynovitis.Methods From October 1998 to March 2008,7 cases of tuberculous tenosynovitis at the wrist,hand and ankle,food were treated using surgery and antitubercular agents.The outcomes,misdiagnosed reason and treatment points and revovery instruction were analyzed respectively.Results All cases were cured.There was no recurrence after postoperative 0.3 to 10 year follow up.Excellent function was obtained in 6 cases.There was 1 case with somewhat disability because of late treatment.Conclusions Early diagnosis of tuberculous tenosynovitis depends on the clinical manifestation、lab test and MRI.Healing could be achieved if focal cleaning,antitubercular medication and functional rehabilitation ware performed on time.

Carpal Tunnel Syndrome caused by tuberculous tenosynovitis in a patient on long-term hemodiaysis / 대한내과학회지

Carpal Tunnel Syndrome (CTS) in patients undergoing long-term hemodialysis is caused by a variety of etiologic factors. Especially deposition of dialysis-related amyloidosis has been regarded as one of important etiologic factors. Although tuberculosis (TB) of wrist is a rare form of extrapulomary TB occurring in approximately 1% of osteoarticular TB in nonuremic patients, occurrence of the CTS as a result of TB tenosynovitis in these patients has been previously reported. To our best knowledge, TB tenosynovitis in hemodialysis patients has not been reported in spite of high incidence of extrapulmonary TB. We report a case of CTS due to TB tenosynovitis in the 53-year-old male receiving hemodialysis for more than eighteen years, confirmed by biopsy in flexor tendon. Initially we made a hasty conclusion that CTS in the patient was caused by dialysis-related amyloidosis.

Carpal Tunnel Syndrome Secondary to Tuberculous Tenosynovitis: A Case Report / 대한정형외과학회잡지

Tuberculosis of the hand and wrist account for less than 1 percent of musculoskeletal tuberculosis cases, and carpal tunnel syndrome secondary to tuberculosis is very rare. Because the symptoms of tuberculosis of the hand and wrist mimic those of rheumatoid synovitis or non-specific chronic synovitis, the final diagnosis and the appropriate treatment may be delayed. We describe the case of a patient who presented with carpal tunnel syndrome secondary to tuberculous tenosynovitis.

A case of tuberculous tenosynocitis / 대한피부과학회지

The sheaths of tendons are an uncommon site of tuberculous invclvement as compared to other parts of the body. But tuberculou, tenosynovitis occurs often enough to varrant particular attention and study. We report a case of tuberculous tenosynovitis occuring in a 49-year-old woman who had multiple yellowish palpable nodules and swellings distributed along the tencon of flexor digitorum superficialis on the left palm for 3 month. Histopathologic findings showed multip e tuberculoid granulomas in the mid-and deep-dermis. Eosinophilic homogenous trabeculated structure(remnants of tendon sheath resistant to necrosis) was present within the area of caseation. Acid-fast stain showed a crowd of acid-fast bacilli in the deep dermis. The cultures from the skin biopsy spec mens on Ogawa media(3% KH PO4) at 24C, 32C and 37C were all negative. She was treated with surgical excision of granulation tissue and involved tendon sheath followed by systemic administration of INH, RIF and ethambutol for 1 year. The lesions were markedly improved and showed no relaps, during last 5 months of follow up period.