Abstract
Tuberculous tenosynovitis is a rare extrapulmonary manifestation of tuberculosis that primarily affects the flexor tendons of the hand and wrist, with less frequent involvement of the extensor tendons. Due to its insidious and nonspecific presentation, diagnosis is often delayed, as symptoms include localized swelling, pain, and restricted movement. We report the case of a 32-year-old male who presented with a four-month history of dorsal hand swelling in the absence of systemic tuberculosis symptoms. Imaging revealed multiple fluid collections involving the extensor tendon compartments with thickened and enhanced synovial sheaths. Surgical drainage was performed, and histopathological examination confirmed a tuberculous etiology. The patient showed significant clinical improvement with standard antituberculosis treatment. This case underscores the diagnostic and therapeutic challenges of tuberculous tenosynovitis, highlighting the critical role of advanced imaging, histopathological confirmation, and timely intervention. A multidisciplinary approach involving radiologists, surgeons, and infectious disease specialists is essential to achieving optimal outcomes in such rare cases.