Open Access
CC BY 4.0 · Indian J Plast Surg 2025; 58(S 01): S5-S148
DOI: 10.1055/s-0045-1813509
Conference Abstracts

Upper Limb Tuberculosis: Navigating Treatment Challenges and Shaping the Future Consensus: An Analysis of Nine Cases

Classification of Study: Case Series

Autoren

  • Karan Khandelwal

    1   Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

  • Kalyan Das

    1   Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Correspondence: Karan Khandelwal (E-mail: dr.karan_khandelwal@rediffmail.com)

Abstract

Background India has the highest TB burden, with approximately 27% of global TB. The state of West Bengal accounts for about 1,02,542 cases of tuberculosis (26,858—EP-TB) in 2023. Around 3% of EP-TB (musculoskeletal) were identified as musculoskeletal TB, and hand involvement is seen in around 10% of the patients with MSK TB. Tenosynovitis is the most common form of the disease in the hand. Presently, there exists a lacuna in the diagnosis and treatment protocol for the management of Tuberculosis of the upper limb; moreover, its incidence and prevalence are not well documented owing to the gaps in the timely identification and diagnosis of the disease.

Aims The aim of the present study is to establish the true incidence of this disease through timely diagnosis and to set a benchmark pertaining to the role of surgery and chemotherapy, guiding the best way forward for optimal functional outcome for the patient.

Methodology This was a prospective study conducted between October 2023 and February 2025 in a tertiary hospital. Patients attending with suspected tuberculosis of soft tissue of the upper limb were included after written consent. A detailed history and examination with routine investigation results were recorded. Most patients presented with tenosynovitis, with some having joint involvement and pathological fractures. Synovectomy was performed for a multicentric lesion. Trucut biopsy was performed for localized lesions, and in scenarios where it was nonspecific, synovectomy was performed.

Results All patients operated (9) were disease-free after 6 months postsurgery and chemotherapy with improvement in hand function as described by hand functional assessment score (fair to satisfactory).

Conclusion Upfront surgery followed by chemotherapy is the best way to move forward for early return of function. A high index of suspicion in an appropriate clinical scenario can identify a subset of patients with upper limb tenosynovitis due to TB.

Keywords: upper-limb TB, tenosynovitis, synovectomy, Tru-cut biopsy



Publikationsverlauf

Artikel online veröffentlicht:
10. November 2025

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