由于结核性关节炎的隐匿发作和非特异性临床表现,因此诊断结核性关节炎可能具有挑战性。早期诊断需要高度怀疑。一名54岁的屠夫因疼痛而被送往骨科诊所,感觉异常和左手腕肿块扩大,这限制了手指的屈曲。患者最初被诊断为腕管综合征(CTS);患者没有结核病(TB)病史,但与动物有直接接触.在临床检查中,在前臂的远端掌侧区域发现了一个小肿块,未观察到淋巴结肿大。尽管有诊断,但患者拒绝接受结核病治疗。经过4个月的时间,患者再次表现出CTS症状。该病例强调了将结核病视为腕管手术持续症状的潜在病因的重要性。早期诊断和迅速开始TB治疗可导致有利的结果并可防止将来复发。
Diagnosing of tuberculous arthritis can be challenging due to its insidious onset and non-specific clinical presentation. A high index of suspicion is required for early diagnosis. A 54-year-old butcher was admitted to an orthopedic clinic with complaints of pain, paresthesia and an enlarging mass in the left wrist, which limited finger flexion. Initially the patient was diagnosed with carpal tunnel syndrome (CTS); the patient had no history of tuberculosis (TB), but had direct contact with animals. On clinical examination, a small mass was found in the distal volar region of the forearm and no lymphadenopathy was observed. Despite the diagnosis the patient refused to receive TB treatment. After a period of 4 months, the patient once again exhibited symptoms of CTS. This
case highlights the importance of considering TB as a potential etiology for persistent symptoms of carpal tunnel surgery. Early diagnosis and prompt initiation of TB treatment can result in favorable outcomes and can prevent future recurrence.