Flexor tenosynovitis due to tuberculosis in hand and wrist

Abstract: The treatment of flexor tenosynovitis in the hand and wrist due to tuberculosis
is controversial. Although some authors recommend the antituberculous
chemotherapy, the others recommend the surgical treatment. In this article,
12 patients with synovial tuberculosis of the flexor aspect of the hand and the
wrist were evaluated with respect to diagnosis and treatment modalities. None
of the patients had a history of tuberculosis, concomitant disease, immunosuppressive
drug use, drug abuse, and human immunodefficiency virus positivity.
A chest x-ray and family screening were performed in all of the cases, none
had evidence of tuberculosis in the lung. The biopsy, histopathological examination,
acid-fast bacillus staining, and BACTEC tuberculosis culture were performed.
Antituberculous chemotherapy was initiated in patients diagnosed with
tuberculosis by either histological or microbiological examinations. The patients
did not undergo any further surgery after biopsy procedures. The lesions
regressed totally in all patients after 3 months of treatment. Carpal tunnel syndrome
symptoms and signs recruited at five months of treatment. In patients with
flexor tuberculosis tenosynovitis, it is possible to achieve good results by applying
only medical therapy after a biopsy, and without the need for further surgery.