Tuberculous tenosynovitis

Discussion:

Classic appearance of rice bodies is demonstrated in this case. Rice bodies are seen in the setting of chronic synovial inflammation like rheumatoid arthritis or TB infection. The patient was initially investigated for soft tissue masses over the dorsal aspect of the wrist. MRI study showed isolated tenosynovitis of the fourth and fifth extensor compartments with synovial thickening and rice bodies. The lack of other rheumatoid features would make the possibility of TB tenosynovitis more likely.

The patient subsequently underwent synovectomy, histology and microbiology results came back positive of mycobacterium tuberculosis. The patient was initiated on anti-TB medications.

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