Tuberculous tenosynovitis of the flexor tendons of the wrist: A case Report.

Introduction Tuberculous tenosynovitis of the flexor tendons of the wrist also referred to, as a compound palmar ganglion is uncommon. It has a classical clinical presentation and histopathology confirms it. Case Presentation We present a case of a 65 year old Ghanaian female with a two-year history of a progressively enlarging dumbbell shaped mass over the volar surface of the right wrist and palm. She did not have a previous history of tuberculosis. However, her Erythrocyte Sedimentation Rate (ESR) was high and Mantoux test was strongly positive (more than 15mm). Radiograph of ulna, radius and wrist showed osteopenic changes of the distal radius. Findings at excision biopsy were inflamed, thickened synovia and rice bodies. Tissue samples were submitted for histological and microbial studies. Anti-tuberculous therapy was commenced on the second postoperative day. Conclusion Tuberculous tenosynovitis of the wrist is uncommon. 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.