Author(s): Achraf Lajmi, Mohamed Ben Jemaa, Ameur Abid, Mohamed Ghorbel, Wassim Zribi and Hassib Keskes

Abstract: Tuberculosis is an infectious disease which represents a real public health problem. Bone and joint involvement is rare. Although its location in the wrist is exceptional, it should always be considered in case of chronic pain especially in endemic countries. We report the case of a 22-year-old young man, from urban origin, who suffered from a painful and inflammatory right wrist developed after a benign trauma. Tuberculin skin test was positive. The search of Mycobacterium tuberculosis in sputum and urine was negative. Laboratory tests showed an inflammatory syndrome without hyper-leukocytosis. A destructive osteo-arthritis was showed by radiological exploration which has been well analyzed by MRI. Surgical drainage and immobilization by external fixation were done. Microbiological culture of per-operative sampling was negative. The search of Mycobacterium tuberculosis on direct examination and culture was negative. Surgical biopsy confirmed the tuberculous origin showing a giant cell granuloma centered by a caseous necrosis indicating then the initiation of anti-tuberculous therapy. After four years of follow-up, a good evolution was noted and the patient had an acceptable useful function. Tuberculosis of the wrist remains a rare location of the disease. It has to be suspected in case of every chronic wrist pain in endemic area. Conservative management offers good results only at early stages.

DOI: 10.22271/27078345.2022.v4.i1b.102

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