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Musculoskeletal Tuberculosis (TB) is an uncommon extrapulmonary manifestation of TB which accounts for 1-3% of TB cases. Here, we report a case of TB of the hand in a patient with systemic lupus erythematosus. The patient was referred to the plastic surgery clinic with a chief complaint of progressive left hand swelling and pain of eleven months’ duration. The MRI was inconclusive, showing synovial inflammation of the mid-palmar space and parona’s space in the wrist. Surgical drainage with acid-fast bacilli staining and histopathology confirmed the diagnosis of TB tenosynovitis of the hand. The patient was started on anti-TB medications and their symptoms improved. After one month, her symptoms returned and she was taken for drainage with tenosynovectomy. Two months postprocedure; she reported improved symptoms with good range of motion. TB of the hand should be suspected in patients with a long history of hand pain and swelling, especially in immunocompromised and autoimmune disease patients. TB medications and surgical intervention are cornerstones in the management of TB tenosynovitis.

Tuberculosis Infection of the Deep Hand Spaces in an SLE Patient : Case Report