Isolated Tuberculous Arthritis of the Wrist Presenting with Rice Bodies: A Case Report
- 1Department of Plastic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Abstract
Background: Tuberculous arthritis of the wrist is an exceptionally rare manifestation of musculoskeletal tuberculosis. Its insidious course and nonspecific presentation often mimic chronic tenosynovitis or ganglion cysts, leading to delayed diagnosis. The intraoperative discovery of rice bodies within the tendon sheath is distinctive, though not pathognomonic. Objectives: To present a rare case of isolated wrist joint tuberculosis with rice bodies, highlighting diagnostic challenges and emphasizing the importance of surgical exploration combined with microbiological confirmation and anti‑tuberculous therapy. Patients and Methods: A 63‑year‑old medically free male presented with a three‑year history of painful wrist swelling following a fishbone puncture. Clinical examination revealed restricted finger extension and incomplete fist closure. MRI demonstrated florid flexor tenosynovitis with multiple intra‑sheath rice bodies. The patient underwent volar tenosynovectomy under regional anesthesia, and specimens were submitted for microbiology, histopathology, and cytology. Results: Intraoperatively, turbid fluid and numerous rice bodies were evacuated. Microbiological culture confirmed Mycobacterium tuberculosis, while histopathology showed chronic inflammatory changes without granulomas. Cytology excluded crystal arthropathy. Postoperatively, the patient commenced systemic anti‑tuberculous therapy and physiotherapy, with early resolution of swelling and improved hand function. Conclusion: Isolated tuberculous arthritis of the wrist is rare and easily misdiagnosed. The presence of rice bodies should raise suspicion for tuberculosis, prompting thorough specimen analysis. Early surgical intervention combined with systemic therapy is essential to prevent disability and achieve favorable outcomes.
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BibTeX
@article{alrefai2026isolated,
title = {{Isolated Tuberculous Arthritis of the Wrist Presenting with Rice Bodies: A Case Report}},
author = {Mohammad Ammar Al-Refai and Omar Elgazzar},
journal = {Egyptian Journal of Plastic and Reconstructive Surgery},
year = {2026},
month = oct,
doi = {10.21608/ejprs.2026.539035.1515},
url = {https://doi.org/10.21608/ejprs.2026.539035.1515},
note = {CC BY},
}
RIS
TY - JOUR
TI - Isolated Tuberculous Arthritis of the Wrist Presenting with Rice Bodies: A Case Report
AU - Mohammad Ammar Al-Refai
AU - Omar Elgazzar
PY - 2026
DA - 2026/10/25
JO - Egyptian Journal of Plastic and Reconstructive Surgery
DO - 10.21608/ejprs.2026.539035.1515
UR - https://doi.org/10.21608/ejprs.2026.539035.1515
AB - Background: Tuberculous arthritis of the wrist is an exceptionally rare manifestation of musculoskeletal tuberculosis. Its insidious course and nonspecific presentation often mimic chronic tenosynovitis or ganglion cysts, leading to delayed diagnosis. The intraoperative discovery of rice bodies within the tendon sheath is distinctive, though not pathognomonic. Objectives: To present a rare case of isolated wrist joint tuberculosis with rice bodies, highlighting diagnostic challenges and emphasizing the importance of surgical exploration combined with microbiological confirmation and anti‑tuberculous therapy. Patients and Methods: A 63‑year‑old medically free male presented with a three‑year history of painful wrist swelling following a fishbone puncture. Clinical examination revealed restricted finger extension and incomplete fist closure. MRI demonstrated florid flexor tenosynovitis with multiple intra‑sheath rice bodies. The patient underwent volar tenosynovectomy under regional anesthesia, and specimens were submitted for microbiology, histopathology, and cytology. Results: Intraoperatively, turbid fluid and numerous rice bodies were evacuated. Microbiological culture confirmed Mycobacterium tuberculosis, while histopathology showed chronic inflammatory changes without granulomas. Cytology excluded crystal arthropathy. Postoperatively, the patient commenced systemic anti‑tuberculous therapy and physiotherapy, with early resolution of swelling and improved hand function. Conclusion: Isolated tuberculous arthritis of the wrist is rare and easily misdiagnosed. The presence of rice bodies should raise suspicion for tuberculosis, prompting thorough specimen analysis. Early surgical intervention combined with systemic therapy is essential to prevent disability and achieve favorable outcomes.
SN - 2974-4709
SN - 1110-0044
ER -