Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in children

Detalhes bibliográficos
Autor(a) principal: Vieira Martins, Miguel
Data de Publicação: 2021
Outros Autores: Santos, Constança, Teixeira, Ana Luísa, Costa, Ricardo, Pon, Jorge, Rodrigues, Carlos
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.25753/BirthGrowthMJ.v30.i3.20302
Resumo: Tuberculosis remains the most common cause of death from infectious diseases worldwide. Extrapulmonary tuberculosis with musculoskeletal involvement occurs in about 10-15% of cases, mainly affecting joints and bones. Of these, only 1-5% are reported as synovitis of the hand. However, prompt diagnosis and treatment are often delayed and, if left untreated, bone and tendon destruction soon ensue and may lead to chronic synovitis. A 15-year-old girl presented with recurrent pain of the hand following trauma. Imaging showed tenosynovitis and tendon rupture. Surgical treatment was performed. Pathological assessment revealed necrotic caseous granulomas. Chest radiography showed no abnormal findings, but both Tuberculin Skin Test and Interferon Gamma-Release Assay were positive. Tuberculous tenosynovitis was diagnosed, and 12-month anti-tuberculous chemotherapy was instated. Five years after surgery, the patient maintained chronic pain and functional hand limitation. Tuberculous tenosynovitis of the hand is a rare and insidious condition that should be considered in the differential diagnosis of chronic hand pain. Delayed diagnosis and treatment can lead to residual functional limitation, making disease recognition critical.
id RCAP_b42435b8e048858b13733c851d2d278a
oai_identifier_str oai:ojs.revistas.rcaap.pt:article/20302
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in childrenTenossinovite crónica da mão – uma apresentação incomum de tuberculose em idade pediátricaCase ReportsTuberculosis remains the most common cause of death from infectious diseases worldwide. Extrapulmonary tuberculosis with musculoskeletal involvement occurs in about 10-15% of cases, mainly affecting joints and bones. Of these, only 1-5% are reported as synovitis of the hand. However, prompt diagnosis and treatment are often delayed and, if left untreated, bone and tendon destruction soon ensue and may lead to chronic synovitis. A 15-year-old girl presented with recurrent pain of the hand following trauma. Imaging showed tenosynovitis and tendon rupture. Surgical treatment was performed. Pathological assessment revealed necrotic caseous granulomas. Chest radiography showed no abnormal findings, but both Tuberculin Skin Test and Interferon Gamma-Release Assay were positive. Tuberculous tenosynovitis was diagnosed, and 12-month anti-tuberculous chemotherapy was instated. Five years after surgery, the patient maintained chronic pain and functional hand limitation. Tuberculous tenosynovitis of the hand is a rare and insidious condition that should be considered in the differential diagnosis of chronic hand pain. Delayed diagnosis and treatment can lead to residual functional limitation, making disease recognition critical.A tuberculose é a principal causa de morte por doença infeciosa globalmente. Em 10-15% dos casos ocorrem manifestações extrapulmonares músculo-esqueléticas, que afetam preferencialmente articulações e ossos. Destas, apenas 1-5% se manifestam como sinovite dos tendões flexores das mãos. O diagnóstico e início de tratamento tardios são frequentes e podem conduzir a sinovite crónica. Uma adolescente de 15 anos apresentou dor recorrente na mão na sequência de traumatismo. Exames radiológicos revelaram tenossinovite e rotura tendinosa. A adolescente foi submetida a tratamento cirúrgico, evidenciando granulomas necróticos caseosos no exame anatomopatológico. Não foram detetadas alterações na radiografia torácica, mas ambos os testes de mantoux e IGRA foram positivos. Foi estabelecido o diagnóstico de tenossinovite tuberculosa e cumprido tratamento durante 12 meses. No entanto, cinco anos após a cirurgia a adolescente mantinha dor crónica e limitação funcional da mão. A tenossinovite tuberculosa da mão é uma doença rara e insidiosa, devendo ser considerada no diagnóstico diferencial de dor crónica da mão. Um diagnóstico e início de tratamento tardios podem levar a dor crónica e limitação funcional do membro, pelo que o reconhecimento da doença é fundamental.Centro Hospitalar Universitário do Porto2021-09-30T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25753/BirthGrowthMJ.v30.i3.20302eng2183-9417Vieira Martins, MiguelSantos, ConstançaTeixeira, Ana LuísaCosta, RicardoPon, JorgeRodrigues, Carlosinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-21T14:55:39Zoai:ojs.revistas.rcaap.pt:article/20302Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:56:32.152987Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in children
Tenossinovite crónica da mão – uma apresentação incomum de tuberculose em idade pediátrica
title Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in children
spellingShingle Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in children
Vieira Martins, Miguel
Case Reports
title_short Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in children
title_full Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in children
title_fullStr Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in children
title_full_unstemmed Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in children
title_sort Chronic tenosynovitis of the hand – an unusual presentation of tuberculosis in children
author Vieira Martins, Miguel
author_facet Vieira Martins, Miguel
Santos, Constança
Teixeira, Ana Luísa
Costa, Ricardo
Pon, Jorge
Rodrigues, Carlos
author_role author
author2 Santos, Constança
Teixeira, Ana Luísa
Costa, Ricardo
Pon, Jorge
Rodrigues, Carlos
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Vieira Martins, Miguel
Santos, Constança
Teixeira, Ana Luísa
Costa, Ricardo
Pon, Jorge
Rodrigues, Carlos
dc.subject.por.fl_str_mv Case Reports
topic Case Reports
description Tuberculosis remains the most common cause of death from infectious diseases worldwide. Extrapulmonary tuberculosis with musculoskeletal involvement occurs in about 10-15% of cases, mainly affecting joints and bones. Of these, only 1-5% are reported as synovitis of the hand. However, prompt diagnosis and treatment are often delayed and, if left untreated, bone and tendon destruction soon ensue and may lead to chronic synovitis. A 15-year-old girl presented with recurrent pain of the hand following trauma. Imaging showed tenosynovitis and tendon rupture. Surgical treatment was performed. Pathological assessment revealed necrotic caseous granulomas. Chest radiography showed no abnormal findings, but both Tuberculin Skin Test and Interferon Gamma-Release Assay were positive. Tuberculous tenosynovitis was diagnosed, and 12-month anti-tuberculous chemotherapy was instated. Five years after surgery, the patient maintained chronic pain and functional hand limitation. Tuberculous tenosynovitis of the hand is a rare and insidious condition that should be considered in the differential diagnosis of chronic hand pain. Delayed diagnosis and treatment can lead to residual functional limitation, making disease recognition critical.
publishDate 2021
dc.date.none.fl_str_mv 2021-09-30T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.25753/BirthGrowthMJ.v30.i3.20302
url https://doi.org/10.25753/BirthGrowthMJ.v30.i3.20302
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2183-9417
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Centro Hospitalar Universitário do Porto
publisher.none.fl_str_mv Centro Hospitalar Universitário do Porto
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799130433386971136

Registros relacionados