Tuberculous Flexor Tenosynovitis with Median Nerve Compression

Abstract

Case: A 65-year-old female patient presented with complaints of diffuse pain and swelling in her right wrist with paresthesia in her right hand with thenar wasting. Her magnetic resonance imaging scan was suggestive of flexor tenosynovitis of the wrist with compression of the median nerve with multiple rice bodies. She underwent excisional biopsy along with median nerve decompression. Mycobacterium tuberculosis was detected by polymerase chain reaction (GeneXpert), and histopathology identified caseous granulomas. The patient was started on antitubercular chemotherapy postoperatively. Conclusion: In endemic countries such as India, tuberculous flexor tenosynovitis must always be a differential diagnosis in cases of wrist swelling with rice bodies.