The sheaths of tendons are uncommon site of tuberculous involvement as compared to other parts of the body, but tuberculous tenosynovitis occurs often enough to warrant particular attention and study.
Tuberculous tenosynovitis was reported to occur more frequently in man than female, in third and fourth decade, in right hand than left, and in palmar side than dorsum.
It has difficulty in diagnosis before operation, but can be definitively diagnosed by the pathologic microscopic examination and guinea-pig inoculattion of rice bodies.
Prominent symptoms of tuberculous tenosynovitis are swelling, pain, stiffiness, crepitation, paresthesias or weakness of grip.
Rice bodies may be found in the sheath of tuberculous tenosynovitis and their histological picture presents chiefly granular and poorlydefined concentrically lamellated masses of coarse granular and threadlike fibrinous material, or tissue which has undergone coagulation necrosis which contains here and there a giant cell and occasionally the tubercle bacillus.
We report herein a case of tuberculous tenosynovitis in a man who have had three round soft masses on the left hand. We had surgical removal of involved tendon sheath and recommended antituberculous medication for an year after operation. Follow-up check at postoperative 18 months, there was no functional disturbance on left hand and no recurrence.
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