Water melon seed bodies in wrist? An unusual and rare case of tuberculous arthritis with water melon seed bodies

Abstract

Tuberculosis primarily affects lungs, though involvement of extra-pulmonary sites is on a relative rise in the backdrop of increased incidence of immune compromised disorders such as HIV/AIDS. The extra-pulmonary sites which are most commonly involved are lymph nodes, genitourinary tract, bone marrow, CNS and musculoskeletal system. Tuberculosis of musculoskeletal system includes bones, joint, bursas and tendons or tenosynovium, the incidence of which is rare. Though tuberculosis involves various parts of musculoskeletal system, involvement of wrist and hand is quite rare. Since the involvement of joints of wrists by tuberculosis is very uncommon. Early diagnosis of tuberculosis of wrist is often difficult, in as much as clinical manifestations of other arthritides mimic tuberculous tenosynovitis. Many times, operative findings of melon seed bodies are characteristically suggestive of tuberculosis. The case being presented here is unique and unusual one, which characteristically presented with intraoperative finding of numerous water melon seed which are considered in literature to be helpful in diagnosis of tuberculous arthritis.