Limits...
Isolated tuberculous tenosynovitis of the anterior tibial and extensor digitorum longus tendons.

Genç B, Solak A, Mayda A, Sen N - J Clin Imaging Sci (2013)

Bottom Line: Imaging studies showed inflammation and infection of the extensor digitorium longus and tibialis anterior tendons.Histopathological studies showed a necrotizing granulomatous inflammation in the synovial tissue.Patient remained infection-free at 26-month follow-up examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Şifa University School of Medicine, İzmir, Turkey.

ABSTRACT
Musculoskeletal system is involved in 1-5% of extrapulmonary cases of tuberculosis. Tuberculous tenosynovitis is a rare form of musculoskeletal tuberculosis. Tuberculosis of the tendon sheath in the hand has been seen in a few cases. Involvement of the tendons of the leg is less common. Diagnosis is not easy as there are no specific clinical symptoms or signs. A 33-year-old male presented with painful swelling in the distal right lower limb that caused restriction of movement. Imaging studies showed inflammation and infection of the extensor digitorium longus and tibialis anterior tendons. Histopathological studies showed a necrotizing granulomatous inflammation in the synovial tissue. A diagnosis of tuberculosis was made and medical treatment was initiated that proved successful. Patient remained infection-free at 26-month follow-up examination.

No MeSH data available.


Related in: MedlinePlus

33-year-old man with painful swelling in the right ankle diagnosed with tuberculous tenosynovitis. (a) Pre-contrast and (b) post-contrast coronal T1-weighted images with gadolinium enhancement show tenosynovitis in the distal portion of the lower limb – thickening of the extensor digitorum longus (white arrows) and anterior tibial (arrow heads) tendons.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3814632&req=5

Figure 1: 33-year-old man with painful swelling in the right ankle diagnosed with tuberculous tenosynovitis. (a) Pre-contrast and (b) post-contrast coronal T1-weighted images with gadolinium enhancement show tenosynovitis in the distal portion of the lower limb – thickening of the extensor digitorum longus (white arrows) and anterior tibial (arrow heads) tendons.

Mentions: On ultrasonography (USG), thickening and decreased echogenicity of extensor digitorum longus and tibialis anterior tendons as well as minimal fluid collection around tendon sheath were observed. Coronal T1-weighted image with gadolinium enhancement showed tenosynovitis in the distal portion of the lower limb [Figure 1a and b]. Axial T1-weighted images at the level of the right tibiotalar joint demonstrated contrast enhancement of the extensor digitorum longus and tibialis anterior tendons surrounding the smooth tissue. The extensor hallucis longus tendon was normal [Figure 2a and b]. Axial fat-suppressed T2-weighted MR image at the level of the right tibiotalar joint showed thickening of the extensor digitorum longus and tibialis anterior tendons, peritendinous edema and minimal fluid within the synovial sheath, edema in the surrounding subcutaneous tissues with loss of fat planes, and increased signal intensity within the tendons [Figure 3].


Isolated tuberculous tenosynovitis of the anterior tibial and extensor digitorum longus tendons.

Genç B, Solak A, Mayda A, Sen N - J Clin Imaging Sci (2013)

33-year-old man with painful swelling in the right ankle diagnosed with tuberculous tenosynovitis. (a) Pre-contrast and (b) post-contrast coronal T1-weighted images with gadolinium enhancement show tenosynovitis in the distal portion of the lower limb – thickening of the extensor digitorum longus (white arrows) and anterior tibial (arrow heads) tendons.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814632&req=5

Figure 1: 33-year-old man with painful swelling in the right ankle diagnosed with tuberculous tenosynovitis. (a) Pre-contrast and (b) post-contrast coronal T1-weighted images with gadolinium enhancement show tenosynovitis in the distal portion of the lower limb – thickening of the extensor digitorum longus (white arrows) and anterior tibial (arrow heads) tendons.
Mentions: On ultrasonography (USG), thickening and decreased echogenicity of extensor digitorum longus and tibialis anterior tendons as well as minimal fluid collection around tendon sheath were observed. Coronal T1-weighted image with gadolinium enhancement showed tenosynovitis in the distal portion of the lower limb [Figure 1a and b]. Axial T1-weighted images at the level of the right tibiotalar joint demonstrated contrast enhancement of the extensor digitorum longus and tibialis anterior tendons surrounding the smooth tissue. The extensor hallucis longus tendon was normal [Figure 2a and b]. Axial fat-suppressed T2-weighted MR image at the level of the right tibiotalar joint showed thickening of the extensor digitorum longus and tibialis anterior tendons, peritendinous edema and minimal fluid within the synovial sheath, edema in the surrounding subcutaneous tissues with loss of fat planes, and increased signal intensity within the tendons [Figure 3].

Bottom Line: Imaging studies showed inflammation and infection of the extensor digitorium longus and tibialis anterior tendons.Histopathological studies showed a necrotizing granulomatous inflammation in the synovial tissue.Patient remained infection-free at 26-month follow-up examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Şifa University School of Medicine, İzmir, Turkey.

ABSTRACT
Musculoskeletal system is involved in 1-5% of extrapulmonary cases of tuberculosis. Tuberculous tenosynovitis is a rare form of musculoskeletal tuberculosis. Tuberculosis of the tendon sheath in the hand has been seen in a few cases. Involvement of the tendons of the leg is less common. Diagnosis is not easy as there are no specific clinical symptoms or signs. A 33-year-old male presented with painful swelling in the distal right lower limb that caused restriction of movement. Imaging studies showed inflammation and infection of the extensor digitorium longus and tibialis anterior tendons. Histopathological studies showed a necrotizing granulomatous inflammation in the synovial tissue. A diagnosis of tuberculosis was made and medical treatment was initiated that proved successful. Patient remained infection-free at 26-month follow-up examination.

No MeSH data available.


Related in: MedlinePlus