Hand Tuberculosis: a Common Disease at an Uncommon Site

Abstract

Tuberculosis (TB) is one of the major health problems in developing countries. India has the highest TB burden with approximately 27% of global TB [6]. (India TB Report 2018 Revised National TB Control Programme (2018)). The most common form of tuberculosis constitutes pulmonary tuberculosis. Among extra pulmonary tuberculosis, the musculoskeletal tuberculosis accounts for about 10–15% cases (Mohd Altaf Mir, Imran Ahmad, Mihd Yaseen (2016) World J Plast Surg 5(3):313–318). Hand involvement is seen in 10% of patients with musculoskeletal disease. There has been recent interest in tuberculosis of the hand because of a rising incidence owing to increasing numbers of immigration, an aging population, and immunosuppressed people including affected patients with human immunodeficiency virus [3,7] (Centre for Disease Control (1995) MMWR 14:1–16), Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Omawi M (2011) J Hand Surg 36:1413–1422). Tuberculous tenosynovial disease (TBTS) is the most common presentation of hand tuberculosis. In the hand, the flexor tendon sheath and radio-ulnar bursae are the most common sites of tenosynovitis. Tuberculosis of hand is more commonly seen in the dominant hand of the male population (Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Omawi M (2011) J Hand Surg 36:1413–1422). Here, we present a case of TBTS affecting extensor compartment of dominant hand in a post renal transplant immunosuppressed individual.

Unveiling Neglected Pin-Site Tuberculosis: An Uncommon Encounter Due to Surgical Distal-End Radius Fracture Management With K-Wires

“…Skeletal involvement occurs in 1-3% of TB patients [ 1 ]. It has been noted that 51% of skeletal TB originates in the spine and extraspinal articulating joints [ 2 ]. Wrist tuberculosis following an infection of the pin site is a very rare presentation.…”

“…Poncet’s disease, or tuberculosis rheumatism, is distinguished from tuberculosis arthritis, as the former condition observed in the acute phase of tuberculosis consists of non-destructive variants of joint inflammation. On the other hand, tuberculosis arthritis manifests in a single joint from which the organism can be recovered [ 2 ]. Tuberculosis arthritis originates with symptoms of synovitis and leads to periarticular demineralization, marginal erosions, and eventually damage of the affected joint [ 3 ].…”