White tumor of the wrist: A rare localization of tuberculosis

AbstractBackgroundTuberculosis (TB) bacteria can infect any bone, joint, tendon, or bursa; however, the most common musculoskeletal site for infection includes the spine and weight-bearing joints of the hip and knee. A tubercular involvement of the wrist is rare.Aim of the workTo describe a rare case of tuberculosis of wrist.Case reportA 37-year-old man with a history of immunosuppressed Human Immunodeficiency Virus (HIV) infection was referred to the Rheumatology department for a 10month history of low-grade fever, swelling and pain in the wrist. X-ray and wrist CT scan, revealed an osteolytic lesion of the wrist. Cold abscess aspiration cytology was negative for acid-fast bacilli but the Polymerase Chain Reaction, using Xpert MTB/RIF (Mycobacterium tuberculosis/resistance to rifampicin) diagnostic test done on the cold abscess fluid was positive in revealing Mycobacterium tuberculosis. The evolution under specific antibiotic treatment has been favorable, with the disappearance of wrist pain and a regression of swelling.ConclusionThis case highlights that TB should be taken into consideration when dealing with nonspecific chronic wrist arthritis, especially if the patient is immunocompromised HIV infected