A case report of tuberculous tenosynovitis of the hand.

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This paper is a report on a case of tuberculous tenosynovitis on the dorsal side of the left hand of a 33-year-old patient.This condition is very rare, and as preoperative diagnosis is extremely difficult, early excision of the lesion is important, as operative findings are essential for the complete diagnosis.In this case, the patient came to our hospital complaining of a pailnless swelling on the dorsal side of his left hand.Preoperatively we diagnosed it as a ganglion and performed excision, but during the operation we recognized a hypertrophied tendon sheath of brown color, containing a lot of "rice bodies", and histological examination clearly indicated tuberculosis.After the operation an additional chest X-ray was taken (apical lordotic view), and a small tuberculous lesion was discovered in the superior lobe of the right lung; though tuberculous bacilli could not be found in cultures from sputum, urine, or gastric juice.For six months after the operation, antituberculous drugs have been employed, and there has been no recurrence of symptoms. Functional prognosis is also extremely good.We suggest therefore that the earlier such an operation is performed, the better the function of the hand can be preserved.
西日本整形・災害外科学会の論文