Observing and treating the tubercular tenosynovitis of ankle tendons: a case report and reviewing the related literature

Abstract

 

Even in countries where tuberculosis (TB) is not uncommon, tenosynovitis rarely occurs. Ankle tendons involvement is much less common than wrist. In this case report, we present a case of ankle tenosynovitis. After diagnostic–therapeutic tenosynovectomy anti-TB treatment was started. No sign of disease relapse was observed after 9 months follow-up. MRI has an important role in diagnosing the cases of tenosynovitis. Magnetic resonance scan shows tendon thickening increases in synovial fluid in tendon sheath. Histopathologic findings of granulomatous inflammation as well as TB culture confirm the diagnosis. Although TB is not the common cause of tenosynovitis in foot, it must be closely studied in differential diagnosis of chronic tenosynovitis in countries where TB is common. Anti-TB treatment is better to be started prior to surgery. And if desired results are not achieved by medical treatment or in case of uncertain diagnosis of the disease, clinical–diagnostic tenosynovectomy must be done.