Clinical and Imaging Findings of Wrist Tuberculosis: A Study of 47 Patients.

Abstract

Purpose: This study aimed to describe the clinical and imaging features of patients with wrist tuberculosis (TB) and to explore the importance of magnetic resonance imaging (MRI) in the evaluation and treatment of wrist TB.

Methods: The clinical and imaging data of 47 patients with wrist TB, diagnosed through a combination of pathological (microbiological culture, polymerase chain reaction, and histopathological examination) and clinical methods, were retrospectively analyzed. The demographic characteristics, clinical symptoms, laboratory tests, and imaging findings of these patients were recorded.

Results: The mean age of the patients was 53.9 ± 15.3 years, and the time from the onset of the patient's symptoms to the diagnosis of wrist TB was 16.2 ± 25.6 months. The main clinical manifestations included wrist pain (100%), wrist swelling (97.9%), and limited wrist joint movement (89.4%). According to the X-ray findings, wrist TB was classified into the synovitis stage (stage I, n = 22; 46.8%) and the bone erosion/destruction stage (stage II, n = 25; 53.2%). The MRI manifestations included bone destruction (87.2%) and synovitis (100%), and other manifestations included joint space narrowing (44.7%), tendon sheath involvement (66.0%), abscess formation (42.6%), and rice body formation (12.8%). Early bone destruction, not seen on plain radiographs (46.8%), was detected by MRI examination. There was an increase in the proportions of dorsal soft tissue abscesses and distal radioulnar joint abscesses detected by MRI examination in stage II patients compared with stage I patients.

Conclusions: MRI can serve as an important adjunct in the diagnosis of wrist TB, offering valuable insights into bone, joint, and soft tissue involvement that may not be visible on plain radiographs.

Type of study/level of evidence: Diagnostic IV.