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Case Report
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| Isolated tuberculosis of the wrist: A rare case of extrapulmonary tuberculosis | ||||||
| Mohamed Altayeb Mussa1, Edmund Fitzgerald O’Connor2, Stuart Waterston2, Michael Taylor3, Fortune Iwuagwu4 | ||||||
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1Orthopaedics Specialist Registrar, Hull Royal Infirmary, 4 School Lane Mews, Beverley, East Riding of Yorkshire, HU17 9LS, United Kingdom.
2Plastic Surgery Specialist Registrar, Mid Essex Hospital, Court Road, Broomfield, Chelmsford, Essex, CM1 7ET, United Kingdom. 3Consultant Orthopaedics and Traumatology, Mid Essex Hospital, Court Road, Broomfield, Chelmsford, Essex, CM1 7ET, United Kingdom. 4Consultant Hand and Plastic surgery, Mid Essex Hospital, Court Road, Broomfield, Chelmsford, Essex, CM1 7ET, United Kingdom. | ||||||
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| How to cite this article: |
| Mussa MA, O’Connor EF, Waterston S, Taylor M, Iwuagwu F. Isolated tuberculosis of the wrist: A rare case of extrapulmonary tuberculosis. International Journal of Case Reports and Images 2013;4(10):541–545. |
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Abstract
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Introduction:
Atypical infections with mycobacteria are unusual in the developed countries and tuberculous involvement of the wrist or carpal bones is a rare presentation.
Case Report: This is a new rare case of tuberculosis of the wrist joint in a non-immunocompromised 24-year-old male without concomitant pulmonary tuberculosis. He then underwent two months course of intra-articular steroid injections and methotrexate therapy for a presumed diagnosis of inflammatory oligoarthritis of the wrist as radiographs were reported as normal. The diagnosis was initially obscured by lack of systemic symptoms and was established by direct visualization of acid-fast bacilli on joint fluid and biopsy of the abscess. Musculoskeletal involvement in tuberculosis may be easily missed because of its non-specific clinical signs. The disease may mimic inflammatory arthritis and high index of suspicion is required when dealing with long standing inflammatory swellings. Conclusion: Persistent swelling of bones or joints can be a presenting sign of tuberculosis. A normal chest radiograph or the absence of systemic symptoms does not exclude the possibility of bone tuberculosis. When confronted with unusual inflammatory findings, always send tissue for histology and alcohol and acid-fast bacilli (AAFB) culture. | |
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Keywords:
Tuberculosis, Wrist, Oligoarthritis, Carpal bones
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Author Contributions
Mohamed Altayeb Mussa – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Edmund Fitzgerald O’Connor – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Stuart Waterston – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Michael Taylor – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Fortune Iwuagwu – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Mohamed Altayeb Mussa et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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