Tuberculous infection of the hand and wrist.

The authors report on 23 patients treated for tuberculosis of the hand and wrist during the past 20 years. Duration of symptoms prior to diagnosis ranged from several months to years. Swelling and pain on motion were common symptoms, as was increased sedimentation rate. Granulomatous inflammation was seen on paraffin section in most of the patients, however tissue cultures were positive for Mycobacterium tuberculosis in only 6 patients in this study. Treatment of these patients were divided into medical and surgical treatments. The incisional biopsy and antituberculous drug were carried out and administered in the medical-treated group for 2 years. The surgical synovectomy as well as debridement and administration of antituberculous drugs were carried out on the surgical group. The results showed no recurrence in this study. Most of the patients showed improved symptoms and an increased range of motion. In conclusion, this treatment resulted in good recovery of function with low morbidity.