Extensors tenosynovitis of wrist with rupture of extensor digitorum: rare presentation of tuberculosis

Majority of the non-pulmonary TB are seen in musculo skeletal system. It’s a chronic and progressive disease that mostly affects weight bearing joints. Upper extremity presentations are not common. Tendon sheaths constitute an uncommon target of extra articular tuberculosis. Tubercular tenosynovitis is now rare, which can delay diagnosis of this disease. Authors report a case of Tuberculosis Tenosynovitis affecting dorsum of hand with pathological rupture of extensor digitorum. A 60 year old male patient present with a progressive swelling over the dorsum of right wrist of 4 month duration. Later he was taken for open excision biopsy. Melon-seed bodies were found inside the exensor tendon sheath with complete rupture of extensor tendon. Case was managed by extensor sheath were excised and removed in total thorough irrigation of the wound was done, retinaculum is repaired, extensor tendons repaired. Histopathology confirmed Tuberculosis. Although the tendon sheath constitutes an uncommon target of extra articular TB, it is one of the leading causes of chronic tendon sheath infection. Hence should be considered in the differential diagnosis of hand masses.