Int J Med Sci 2023; 20(7):985-992. doi:10.7150/ijms.84727 This issue Cite

Research Paper

Clinical characteristics and treatment outcomes of tuberculous tenosynovitis of the hand and wrist

Cao Thanh Ngoc1,2*, Nguyen Chau Tuan2, Nguyen Phuc Thinh3, Nguyen Minh Duc4*✉

1. Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
2. Department of Rheumatology, University Medical Center HCMC, Ho Chi Minh City, Vietnam.
3. Department of Orthopedics, University Medical Center HCMC, Ho Chi Minh City, Vietnam.
4. Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
*These authors contributed equally to this article as co-first authors.

Citation:
Ngoc CT, Tuan NC, Thinh NP, Duc NM. Clinical characteristics and treatment outcomes of tuberculous tenosynovitis of the hand and wrist. Int J Med Sci 2023; 20(7):985-992. doi:10.7150/ijms.84727. https://www.medsci.org/v20p0985.htm
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Abstract

Graphic abstract

Objective: Vietnam is endemic with tuberculosis (TB), which is highly prevalent in the community. TB tenosynovitis of the wrist and hand is uncommon. Because of its insidious progression and atypical presentations, it is often difficult to diagnose, leading to treatment delays. This study investigates the characteristics of clinical and subclinical signs and treatment outcomes of patients with TB tenosynovitis in Vietnam.

Patients and Methods: This prospective longitudinal cross-sectional study included 25 TB tenosynovitis patients in the Rheumatology Clinic at University Medical Center Ho Chi Minh City. The diagnosis was made based on a tuberculous cyst in histopathological specimens. The data were collected through medical history, physical examination, and medical records, including demographics, signs, symptoms, condition duration, and related laboratory tests and imaging. The outcomes of all participants were assessed after 12 months of treatment.

Results: The most common symptom of TB tenosynovitis was swelling of the hand and wrist, which was present in all patients. Its other symptoms included mild pain and numbness of the hand in 72% and 24% of patients, respectively. It can affect any site on the hand. Hand ultrasound findings included thickening of the synovial membrane (80%), peritendinous effusion (64%), and soft tissue swelling (88%). Most patients (18/22) had a good outcome after the treatment with anti-tubercular drugs.

Conclusions: TB tenosynovitis progression is often insidious. Its most common symptoms are swelling of the hand and mild pain. Ultrasound is a useful tool to support the diagnosis. A histological examination confirms the diagnosis. Most cases respond and have a good outcome after 9-12 months of anti-tuberculosis treatment.

Keywords: tuberculosis, tenosynovitis, wrist, hand


Citation styles

APA
Ngoc, C.T., Tuan, N.C., Thinh, N.P., Duc, N.M. (2023). Clinical characteristics and treatment outcomes of tuberculous tenosynovitis of the hand and wrist. International Journal of Medical Sciences, 20(7), 985-992. https://doi.org/10.7150/ijms.84727.

ACS
Ngoc, C.T.; Tuan, N.C.; Thinh, N.P.; Duc, N.M. Clinical characteristics and treatment outcomes of tuberculous tenosynovitis of the hand and wrist. Int. J. Med. Sci. 2023, 20 (7), 985-992. DOI: 10.7150/ijms.84727.

NLM
Ngoc CT, Tuan NC, Thinh NP, Duc NM. Clinical characteristics and treatment outcomes of tuberculous tenosynovitis of the hand and wrist. Int J Med Sci 2023; 20(7):985-992. doi:10.7150/ijms.84727. https://www.medsci.org/v20p0985.htm

CSE
Ngoc CT, Tuan NC, Thinh NP, Duc NM. 2023. Clinical characteristics and treatment outcomes of tuberculous tenosynovitis of the hand and wrist. Int J Med Sci. 20(7):985-992.

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