Korean J Radiol.  2011 Dec;12(6):745-749. 10.3348/kjr.2011.12.6.745.

Nontuberculous Mycobacterial Tenosynovitis in the Hand: Two Case Reports with the MR Imaging Findings

• Yoon HJ
• Kwon JW
• Yoon YC
• Choi SH

• KMID: 1101930
• DOI: http://doi.org/10.3348/kjr.2011.12.6.745

Abstract

Nontuberculous mycobacterial infections can cause destructive tenosynovitis of the hand. We report on and discuss the clinical course and distinctive radiologic findings of two patients with hand tenosynovitis secondary to M. marinum and intracellulare infection, which are different from those of the nontuberculous mycobacterial infections reported in the previous literature.

Keyword

Mycobacteria, atypical; Tenosynovitis; Hand; Radiography; Magnetic Resonance Imaging

MeSH Terms

Female
*Hand/radiography
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Mycobacterium Infections, Nontuberculous/*diagnosis/etiology/radiography
Mycobacterium avium-intracellulare Infection/*diagnosis/etiology/radiography
*Mycobacterium marinum
Surgical Wound Infection/complications
Tenosynovitis/diagnosis/*microbiology/radiography
Wound Infection/complications

Figure

• 

  Fig. 1 59-year-old male, fisherman, with swelling, erythema, ulceration and pain in right hand. A. Radiograph shows diffuse soft tissue swelling of second and third right fingers without bone erosions. B. Axial T2-weighted MR image shows tenosynovitis around second and third fingers with soft tissue edema. Extensor tendon of second digit is focally disrupted (arrow). C. Axial fat-suppressed T1-weighted image with gadolinium enhancement shows diffuse enhancement along extensor tendon sheaths with tear of sheath at second finger (arrow). Adjacent bone marrow enhancement is also noted (arrowhead).

• 

  Fig. 2 63-year-old woman with volar side pain of left wrist. A. Axial fat-suppressed T2-weighted MR image shows thickening and increased signal intensity of flexor tendon sheaths. B, C. Precontrast (B) and postcontrast (C) T1-weighted MR images show diffuse peripheral enhancement, suggesting exuberant tenosynovitis. Flexor tendons are intact and no signal changes of bone marrow are noted. D. Coronal T1-weighted image with gadolinium enhancement shows tenosynovitis from wrist to distal portion of second digit. E. Radiograph (oblique view) obtained four years after initial visit shows bony erosions along margin of left radiocarpal bones with osteoporotic change (black arrows) and round mass at volar aspect (white arrow). F. Radiograph (posteroanterior view) obtained four years after initial visit shows widening of scapholunate joint space (black arrow).

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