Presentation
We present a case of a 65-year-old Ghanaian female. She presented a progressively enlarging mass over the volar aspect of the right wrist and palm. She did not have a previous history of tuberculosis. [ncbi.nlm.nih.gov]
The interval to presentation ranged from 1 week to 2 years. Two patients had median nerve irritation, 3 patients had osteomyelitis, and 1 patient had flexor tendon rupture. [scholarbank.nus.sg]
Respiratoric
- Pneumonia
A15 Respiratory tuberculosis, bacteriologically and histologically confirmed A15.0 Tuberculosis of lung, confirmed by sputum microscopy with or without culture Tuberculous: · bronchiectasis · fibrosis of lung · pneumonia · pneumothorax } } } } confirmed [apps.who.int]
Suppurative flexor tenosynovitis after accidental self-inoculation with Streptococcus pneumoniae type I. JAMA. 1984 Dec 7. 252(21):3003-4. [Medline]. Wright TW, Linscheid RL, O'Duffy JD. [emedicine.medscape.com]
Skin
- Angioedema
[…] patient Tenosynovitis Tietzes disease Tophaceous gout Toxic oil syndrome Toxic shock syndrome Trigger finger Tuberculoid leprosy Tuberculosis Tumescent fluid or iv overload (see letters Worland + Duncan) Tumoral calcinosis Upper limb hypertrophy Vibratory angioedema [carpal-tunnel.net]
Workup
Radiological assessment is often the first step in the diagnostic workup of patients with musculoskeletal TB and further investigations are decided by the findings on radiography. [faoj.org]
Imaging Obtain standard anteroposterior and lateral radiographs to rule out bony involvement or a foreign body. [1] See Workup for more detail. [emedicine.medscape.com]
Treatment
Emergent treatment includes surgical debridement and the institution of early anti-TB therapy immediately after completing histopathological examination. [ncbi.nlm.nih.gov]
Table II Treatment options available in the literature. [mltj.org]
Practical, clinically relevant material facilitates the diagnosis and treatment of musculoskeletal, pain, and chronic disabling conditions. [books.google.de]
Prognosis
"Factors affecting the prognosis of pyogenic flexor tenosynovitis". The Journal of Bone and Joint Surgery. American Volume. 89 (8): 1742–8. doi : 10.2106/JBJS.F.01356. PMID 17671013. ^ Nikkhah, D; Rodrigues, J; Osman, K; Dejager, L (2012). [en.wikipedia.org]
In that situation, a debulking tenosynovectomy and chemotherapy is a must for a better prognosis. [ijcasereportsandimages.com]
[…] para-articular abscess, tenosynovitis, bursitis, skin ulceration or sinus tract formation): sinus tracts appear linear T2 hyperintensity with marginal ‘tram-track enhancement’ para-articular abscesses have thin, smooth and enhancing wall Treatment and prognosis [radiopaedia.org]
Cases of infectious FT that present early and have no comorbidities have a good prognosis. [emedicine.medscape.com]
[…] symps, can't tell from ankylosing spondylitis Extraarticular involvement in Reactive arthritis Inflam balanitis (Circinate) Keratoderma blenorrhagica Plaques / erosions of tongue/hands Conjuctivitis Cardiac conduction abnormalities Aortic regurgitation Prognosis [studyblue.com]
Etiology
This diagnosis, although rare, should be considered as the etiology in a carpal tunnel syndrome, particularly when there is evidence of a proliferative tenosynovitis and radiographs show diffuse osteoporosis. [ncbi.nlm.nih.gov]
Clinical manifestations differ depending on etiologies. [e-aps.org]
[…] discuss the etiologies, clinical and morphologic features of suppurative arthritis Thoro History, Aspiration & CBC Gonococcus - most common S. aureus - IV drug, MRSA Strep E-coli, Samonella (sickel cell & SLE), Pseudomonas Eikenella - human bite; Fungi [quizlet.com]
The differential diagnosis of granulomatous inflammation in a tissue specimen include infectious etiologies such as Mycobacterium tuberculosis, atypical mycobacteria, various fungi, Brucella species, and non-infectious etiologies such as sarcoidosis, [path.upmc.edu]
Epidemiology
The book also provides updated epidemiologic and statistical data throughout and includes a section on biostatistics in physical medicine and rehabilitation. [books.google.de]
The criteria to differentiate tuberculous from non-infectious tenosynovitis are: young age, male sex, specific epidemiological factors, elevated erythrocyte sedimentation rate, marked local swelling, association with other foci of tuberculosis, unusual [rsroc.org.tw]
WHO: Publication Weekly Epidemiological Record, No. 5, Date 3 rd Feb 2006. An Old Disease. Clin Orthop 2002;398:32-9. 6. Wali H, Al-Khuwaitir S, Hafeez MA. Compound palmar ganglion: A case report and literature review. [joas.in]
The ultimate consequences are tendon necrosis, disruption of the tendon sheath, and digital contracture. [18, 19] Epidemiology Infectious flexor tenosynovitis No data exist regarding the incidence of infectious FT. [emedicine.medscape.com]
Pathophysiology
(See Pathophysiology and Etiology.) Much of the original work on infectious FT was done by Kanavel. [emedicine.medscape.com]
Prevention
However, in developing countries like Ghana where tuberculosis is prevalent, it should be part of the differential diagnosis of compound palmar ganglion in order to prevent delayed diagnosis and treatment. [ncbi.nlm.nih.gov]
Can Be Treated (Centers for Disease Control and Prevention) Tuberculosis Facts - Testing for TB (Centers for Disease Control and Prevention) Tuberculosis Facts - You Can Prevent TB (Centers for Disease Control and Prevention) Tuberculosis: General Information [icdlist.com]
Prevention aspects and legal-medical evaluation. Med Lav [Internet]. 2010 Jan. 2 [cited 2022 Oct. 26];101(1):26-9. [mattioli1885journals.com]
Develop a thorough, clinically relevant understanding of interventions such as physical agents and therapeutic exercise in the prevention, diagnosis, treatment, and rehabilitation of disorders that produce pain, impairment, and disability. [books.google.de]
Once infected, it can lead to the carpal tunnel syndrome due to the median nerve compression, [2] however, early surgical debridement can prevent the destruction of the surrounding bones. [sjosm.org]