Tuberculous Tenosynovitis of Flexor Tendon of the Hand

수부 굴곡건에 발생한 결핵성건초염

  • Min, Hee-Joon (Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine) ;
  • Chung, Yoon-Kyu (Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine)
  • 민희준 (연세대학교 원주의과대학 원주기독병원 성형외과학교실) ;
  • 정윤규 (연세대학교 원주의과대학 원주기독병원 성형외과학교실)
  • Received : 2010.05.03
  • Accepted : 2010.06.14
  • Published : 2010.09.10

Abstract

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. Method: 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. Result: 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.

Keywords

References

  1. Bickel WH, Kimbrough RF, Dahlin DC: Tuberculous tenosynovitis. J Am Med Assoc 151: 31, 1953
  2. Kim ID, Lee SY, Ihin JC, Kwaeng KW, Chung JM: Tuberculous tenosynovitis. J Korean Orthop Assoc 14: 561,1979
  3. Leung PC: Tuberculosis of the hand. Hand 10: 285, 1978 https://doi.org/10.1016/S0072-968X(78)80052-7
  4. Pimm LH, Waugh W: Tuberculous tenosynovitis. J Bone Joint Surg 39: 91, 1957 https://doi.org/10.2106/00004623-195739010-00010
  5. Robin RH: Tuberculosis of the wrist and hand. Br J Surg 54: 211, 1967 https://doi.org/10.1002/bjs.1800540314
  6. Kanavel AB: Tuberculous tenosynovitis of the hand. Surg Gynecol Obstet 37: 635, 1923
  7. Bush DC, Scheider LH: Tuberculosis of the hand and wrist. J Hand Surg Am 9: 391, 1984 https://doi.org/10.1016/S0363-5023(84)80230-0
  8. Mason ML: Tuberculous tenosynovitis of the hand. Surg Gynecol Obstet 59: 363, 1934