# A Rare Manifestation of Extrapulmonary Tuberculosis: Tenosynovitis of Wrist and Multiple Fingers

## TL;DR

A rare case of tuberculosis affecting the wrist and fingers is reported, emphasizing the need for early diagnosis and combined treatment in endemic regions.

## Contribution

This paper presents a unique clinical case of tuberculous tenosynovitis and emphasizes the importance of histopathological confirmation and combined treatment.

## Key findings

- Tuberculous tenosynovitis was confirmed via histopathology in a 39-year-old male with chronic wrist and finger symptoms.
- Surgical synovectomy combined with six months of anti-tuberculosis therapy led to significant clinical improvement.
- The case highlights the importance of considering tuberculosis in chronic tenosynovitis in endemic regions.

## Abstract

Tuberculous tenosynovitis is a rare extrapulmonary manifestation of tuberculosis and often presents with nonspecific symptoms that mimic more common inflammatory or degenerative conditions. We report a unique case from Eastern Morocco involving a 39-year-old male with a two-year history of progressive swelling and limited flexion of the wrist and the second, third, and fifth fingers. Imaging revealed tenosynovitis of the flexor tendons, and histopathological examination confirmed tuberculosis through the presence of granulomatous inflammation with caseous necrosis. The patient underwent a surgical synovectomy followed by a six-month course of anti-tuberculosis therapy, resulting in significant clinical improvement and restored joint mobility. This case underscores the importance of considering tuberculosis in the differential diagnosis of chronic tenosynovitis, particularly in endemic regions. It highlights the role of early histopathological confirmation and combined medical-surgical management in achieving favorable outcomes.