A rare case of Tuberculous tenosynovitis in the palm of the hand in Gilan

A 64-year-old woman with no history of previous illness presented with  a soft tissue swelling of the flexor surfaces of the second finger of the left hand and also palmar surfaces of the same hand without pain and with 2 nodules 1 by 1 cm in that area for about 5 months.  After debridement and excisional biopsy, histopathological examination reported caseous necrotizing granulomatous inflammation.The patient underwent anti-tuberculosis treatment for 6 months.Tuberculosis Tenosynovitis occurs in the palm of the hand. If not diagnosed early, it can lead to functional impairment of the hand by spreading to nearby soft tissues, bone and joint, and may lead to carpal tunnel syndrome. Confirmation of the diagnosis is by excisional biopsy of soft tissue and its nodules and sending for histopathologic examination and acid fast Mycobacterial culture. If the bones and joints are not involved, the anti-tuberculosis treatment will improve it by 6 month treatment. Increased diagnostic awareness and suspicion of this disease leads to timely diagnosis and appropriate treatment and prevents functional disorders.