Article


A Prospective Study on Wrist Tuberculosis: Challenges in Diagnosis and Management

Ram Shah, K.1*, Ankit Shrivastava2, Sujan Paudel, R.3 & Rajesh Das, C.4

1Professor and Head, Department of Orthopaedics, Janaki Medical College, Janakpurdham, Nepal
2Orthopaedic Surgeon, Janakpur Trauma Hospital, Janakpurdham, Nepal
3Consultant Orthopaedic Surgeon, Scheer Memorial Adventist Hospital, Banepa, Nepal
4Associate Professor, Department of Medicine, Janaki Medical College, Janakpurdham, Nepal

Dr. Ram Shah, K., Professor and Head, Department of Orthopaedics, Janaki Medical College, Janakpurdham, Nepal.

Keywords: Wrist Tuberculosis; Chemotherapy; Rheumatology

Abstract

Introduction
Wrist Joint is an uncommon site for tubercular infection. However, it is more commonly seen in south-east Asia than in developed parts of the world. The diagnosis is often delayed, because of its rarity and hence many patients have to live with longterm sequale of stiffness and pain.
Materials and Methods
Twenty two (22) patients presenting with wrist joint tuberculosis between January 2013 and January 2018 were treated with antitubercular drugs, splinting and were prospectively followed up for a minimum of 18 months duration. The evaluation of outcome was based on Patient Rated Wrist Evaluation.
Results
Seventeen (17) patients had microbiological or histopathological confirmation of diagnosis. Five (5) patients with high clinical suspicion and negative diagnostic workup were also treated for tubercular arthritis. Mean Patient Rated Wrist Evaluation improved from 115 at the beginning to 31 at 18 months.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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