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Tuberculous arthropathy of wrist

Case contributed by Tamsir Rongpipi
Diagnosis almost certain

Presentation

History of swelling and limitation of movements for 2 years with recurrent pain.

Patient Data

Age: 60 years
Gender: Female

Wrist

x-ray

Erosions with destructions of the distal radius and ulna. Reduction in the height of scaphoid and lunate carpal bones with erosions & destruction. Soft tissue swelling is also seen.

Gross destruction and erosions seen in the proximal carpal bones, distal radius and ulna with peripherally enhancing collections seen filling the entire wrist joint and associated with adjacent soft tissue swelling and synovial thickening.

Few areas of marrow edema and erosions are also seen in the distal carpal row.

Marrow edema is seen in distal radius and ulna, the rest of the visualized parts of radius and ulna show normal marrow signal.

Case Discussion

Musculoskeletal tuberculosis compromise about 10% of all extra-pulmonary tuberculosis of which wrist tuberculous arthritis is rare. Extra-pulmonary tuberculosis is seen mainly in developing countries.

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