Please use this identifier to cite or link to this item: https://doi.org/10.1097/SAP.0b013e3181e35ca5
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dc.titleRice bodies, millet seeds, and melon seeds in tuberculous tenosynovitis of the hand and wrist
dc.contributor.authorWoon, C.Y.-L.
dc.contributor.authorPhoon, E.-S.
dc.contributor.authorLee, J.Y.-L.
dc.contributor.authorPuhaindran, M.E.
dc.contributor.authorPeng, Y.-P.
dc.contributor.authorTeoh, L.-C.
dc.date.accessioned2016-09-07T05:36:32Z
dc.date.available2016-09-07T05:36:32Z
dc.date.issued2011-06
dc.identifier.citationWoon, C.Y.-L., Phoon, E.-S., Lee, J.Y.-L., Puhaindran, M.E., Peng, Y.-P., Teoh, L.-C. (2011-06). Rice bodies, millet seeds, and melon seeds in tuberculous tenosynovitis of the hand and wrist. Annals of Plastic Surgery 66 (6) : 610-617. ScholarBank@NUS Repository. https://doi.org/10.1097/SAP.0b013e3181e35ca5
dc.identifier.issn01487043
dc.identifier.urihttp://scholarbank.nus.edu.sg/handle/10635/127084
dc.description.abstractTuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. Operative findings of "rice bodies, millet seeds, or melon seeds" are highly suggestive of tuberculous tenosynovitis. Six patients with TB of the hand and wrist at various stages of disease with characteristic operative findings are reviewed. Four patients had underlying immunosuppression. One patient had previous pulmonary TB, whereas 3 patients had radiographic evidence of previously undiagnosed pulmonary TB. The interval to presentation ranged from 1 week to 2 years. Two patients had median nerve irritation, 3 patients had osteomyelitis, and 1 patient had flexor tendon rupture. Mycobacterial cultures were positive in 4 patients; acid-fast bacilli stain, and polymerase chain reaction were positive in remaining 1 patient; and both stain and culture were negative in the last patient who had history of pulmonary TB. All 6 patients were managed with combination therapy comprising antituberculous chemotherapy and at least 1 debulking tenosynovectomy. Two patients had 2 debridements. Of these 2 patients, 1 underwent wrist arthrodesis during the second procedure. Mean follow-up was 4 years. There were no recurrences after the most recent debridement. The diagnosis of TB of the hand and wrist is often missed. The surgeon has to be aware of the significance of loose bodies when performing routine excision of innocuous looking wrist ganglia. Combination therapy comprising thorough excisional debridement and antituberculous chemotherapy will minimize recurrence of this difficult-to-treat disease. Copyright © 2011 by Lippincott Williams & Wilkins.
dc.description.urihttp://libproxy1.nus.edu.sg/login?url=http://dx.doi.org/10.1097/SAP.0b013e3181e35ca5
dc.sourceScopus
dc.subjectbursitis
dc.subjectinfection
dc.subjectmagnetic resonance imaging
dc.subjecttenosynovitis
dc.subjecttuberculosis
dc.typeArticle
dc.contributor.departmentORTHOPAEDIC SURGERY
dc.description.doi10.1097/SAP.0b013e3181e35ca5
dc.description.sourcetitleAnnals of Plastic Surgery
dc.description.volume66
dc.description.issue6
dc.description.page610-617
dc.description.codenAPCSD
dc.identifier.isiut000290476500007
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