Tuberculous Tenosynovitis of the Tibialis Anterior Tendon: A Case Report

Abstract

Tuberculous tenosynovitis is an uncommon form of extrapulmonary tuberculosis occurring primarily in the hands and wrists with limited reports involving the lower extremities. We report a rare case of tuberculous tenosynovitis of the tibialis anterior tendon occurring in a 37-year-old Filipino male. The tendon was surgically debrided and the patient was given a six month course of antituberculin chemotherapy. At one year postoperatively, the patient has good function with no evidence of recurrence.

Tuberculous tenosynovitis

“…TB tenosynovitis has a tendency for local recurrence, with more than 50% of cases recurring within 1 year of treatment. 2,7 Recurrence as late as 36 years after the initial treatment has been reported, 8 stressing the need for immediate close supervision and longterm follow-up. Isolated medical or surgical treatment alone significantly increases the risk of recurrence.…”

“…3 Medical therapy should be based on general recommendations for treating extrapulmonary TB. 7 Surgical treatment varies depending on the extent of the disease and may include limited excision of the infected tissue, synovectomy, or wide debridement of soft and bony tissue. TB tenosynovitis has a tendency for local recurrence, with more than 50% of cases recurring within 1 year of treatment.…”

Ténosynovite tuberculeuse de la gaine des tendons fibulaires

“…Sa rareté et sa capacité à mimer d'autres maladies musculosquelettiques en font une pathologie sous-diagnostiquée [1]. Selon Hooker et al [2], elle atteint principalement le poignet et la main qui représen-tent 5 % des localisations tuberculeuses. Sa localisation au niveau du membre inférieur, et en particulier la gaine des tendons fibulaires, est exceptionnelle [3,4].…”

An undiagnosed pleural effusion with surprising consequences

“…Extrapulmonary tuberculosis involvement of the musculoskeletal system is uncommon, accounting for only 1% to 5% of cases [1]. Even less common in musculoskeletal TB is the involvement of the joint tendons, producing tuberculous tenosynovitis [2], [3]; involvement of the wrist is uncommon, occurring in less than 1% of cases [4].…”