Tuberculosis of Tendon Sheath

Tuberculosis of tendon sheath, often referred to as extrapulmonary tuberculosis, is a rare but serious condition that affects the tissues surrounding tendons in the body. This article aims to provide a clear and concise overview of this condition, including its types, causes, symptoms, diagnosis methods, treatments, surgeries, prevention strategies, and when to seek medical attention.


Tuberculosis of tendon sheath can occur in various parts of the body, including the hands, feet, wrists, and ankles.


  1. Mycobacterium tuberculosis Infection: The primary cause of tuberculosis of tendon sheath is infection with the bacterium Mycobacterium tuberculosis.
  2. Weak Immune System: Individuals with weakened immune systems due to conditions such as HIV/AIDS or certain medications are at a higher risk.
  3. Close Contact: Close contact with someone who has active tuberculosis can increase the risk of infection.
  4. Poor Living Conditions: Living in crowded or unsanitary conditions can also contribute to the spread of tuberculosis.
  5. Malnutrition: Poor nutrition can weaken the immune system, making individuals more susceptible to tuberculosis infection.
  6. Smoking: Smoking can compromise lung function and increase the risk of tuberculosis infection.
  7. Alcohol Abuse: Excessive alcohol consumption can weaken the immune system, making individuals more vulnerable to infections.
  8. Healthcare Settings: Healthcare workers may be at an increased risk of tuberculosis exposure in certain settings.
  9. Traveling to High-Risk Areas: Traveling to regions where tuberculosis is more prevalent can increase the risk of infection.
  10. Age: Older adults may be at a higher risk of developing tuberculosis of tendon sheath.
  11. Chronic Illnesses: Certain chronic illnesses, such as diabetes or kidney disease, can weaken the immune system and increase susceptibility to tuberculosis.
  12. Intravenous Drug Use: Sharing needles or using contaminated equipment for intravenous drug use can increase the risk of tuberculosis transmission.
  13. Prison Settings: Living in crowded and poorly ventilated prison settings can facilitate the spread of tuberculosis.
  14. Migration: Migration from regions with high rates of tuberculosis can increase the risk of infection.
  15. Genetic Factors: Some genetic factors may predispose individuals to tuberculosis infection.
  16. Occupational Exposure: Certain occupations, such as healthcare workers or miners, may have an increased risk of tuberculosis exposure.
  17. Airborne Transmission: Tuberculosis is primarily spread through the air when an infected person coughs or sneezes.
  18. Drug Resistance: The emergence of drug-resistant strains of tuberculosis poses a significant challenge for treatment.
  19. Poor Hygiene: Poor personal hygiene practices can increase the risk of tuberculosis transmission.
  20. Crowded Living Conditions: Living in crowded households or dormitories can facilitate the spread of tuberculosis.


  1. Pain: Pain in the affected tendon sheath area.
  2. Swelling: Swelling and inflammation around the tendon.
  3. Stiffness: Stiffness and limited range of motion in the affected joint.
  4. Warmth: Increased warmth in the affected area.
  5. Redness: Redness and tenderness around the affected tendon sheath.
  6. Difficulty Moving: Difficulty moving the affected joint.
  7. Fever: Low-grade fever.
  8. Fatigue: General fatigue and weakness.
  9. Night Sweats: Excessive sweating, especially at night.
  10. Weight Loss: Unintentional weight loss.
  11. Loss of Appetite: Decreased appetite.
  12. Chills: Chills or shivering.
  13. Weakness: Weakness in the affected limb.
  14. Nausea: Nausea and vomiting.
  15. Joint Deformity: In severe cases, joint deformity may occur.
  16. Tenderness: Tenderness to touch around the affected area.
  17. Formation of Abscess: Formation of abscess or collection of pus.
  18. Difficulty Grasping: Difficulty grasping objects with the affected hand.
  19. Skin Changes: Changes in the color or texture of the skin overlying the affected tendon sheath.
  20. Nerve Compression Symptoms: Symptoms of nerve compression if adjacent nerves are affected.

Diagnostic Tests:

  1. Physical Examination: A healthcare provider will perform a physical examination to assess the affected joint and surrounding tissues.
  2. Medical History: Gathering information about the patient’s medical history, including any previous tuberculosis exposure or infections.
  3. Tuberculin Skin Test: A tuberculin skin test, also known as a Mantoux test, may be performed to check for exposure to tuberculosis.
  4. Blood Tests: Blood tests, such as interferon-gamma release assays (IGRAs) or polymerase chain reaction (PCR) tests, can help detect the presence of tuberculosis bacteria.
  5. Imaging Studies: Imaging studies, such as X-rays, ultrasound, or MRI scans, may be used to visualize the affected joint and surrounding structures.
  6. Aspiration and Culture: Aspiration of fluid from the affected joint may be performed to check for the presence of tuberculosis bacteria.
  7. Biopsy: In some cases, a biopsy of the affected tissue may be necessary to confirm the diagnosis.
  8. Genetic Testing: Genetic testing may be used to identify drug-resistant strains of tuberculosis.
  9. Histopathological Examination: Examination of tissue samples under a microscope to look for characteristic changes associated with tuberculosis infection.
  10. Lymph Node Biopsy: If lymph nodes are affected, a biopsy of the lymph node may be performed.

Non-Pharmacological Treatments:

  1. Rest: Resting the affected joint to reduce inflammation and promote healing.
  2. Immobilization: Immobilizing the affected joint with a splint or brace to prevent further damage.
  3. Physical Therapy: Physical therapy exercises to improve joint mobility and strength.
  4. Heat and Cold Therapy: Applying heat or cold packs to the affected area to reduce pain and inflammation.
  5. Massage Therapy: Gentle massage of the affected area to promote circulation and reduce stiffness.
  6. Joint Protection: Avoiding activities that exacerbate symptoms and practicing joint protection techniques.
  7. Occupational Therapy: Occupational therapy to learn adaptive techniques for performing daily activities with limited joint mobility.
  8. Assistive Devices: Using assistive devices such as canes or walkers to reduce pressure on the affected joint.
  9. Hydrotherapy: Hydrotherapy exercises in warm water to improve joint mobility and reduce pain.
  10. Acupuncture: Acupuncture may help alleviate pain and promote relaxation.
  11. Transcutaneous Electrical Nerve Stimulation (TENS): TENS therapy uses electrical impulses to relieve pain.
  12. Stretching Exercises: Gentle stretching exercises to improve flexibility and range of motion.
  13. Stress Management: Stress management techniques such as meditation or deep breathing exercises.
  14. Proper Nutrition: Eating a balanced diet rich in vitamins and minerals to support overall health and healing.
  15. Weight Management: Maintaining a healthy weight to reduce stress on the affected joints.
  16. Smoking Cessation: Quitting smoking to improve lung function and overall health.
  17. Alcohol Moderation: Moderating alcohol consumption to reduce inflammation and improve immune function.
  18. Sleep Hygiene: Practicing good sleep hygiene habits to promote restful sleep and healing.
  19. Social Support: Seeking support from friends, family, or support groups to cope with the challenges of living with tuberculosis of tendon sheath.
  20. Education: Educating oneself about the condition and adhering to treatment recommendations.


  1. Antibiotics: Antibiotics such as isoniazid, rifampin, ethambutol, and pyrazinamide are commonly used to treat tuberculosis infections.
  2. Anti-Inflammatory Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be prescribed to reduce pain and inflammation.
  3. Analgesics: Pain relievers such as acetaminophen or tramadol may be used to alleviate discomfort.
  4. Corticosteroids: Corticosteroid medications may be prescribed to reduce inflammation and swelling in severe cases.
  5. Immunosuppressants: Immunosuppressive drugs may be used to modulate the immune response in certain individuals.
  6. Antiretroviral Drugs: Antiretroviral medications are used to treat HIV/AIDS-related tuberculosis infections.
  7. Nutritional Supplements: Supplements such as vitamin D or calcium may be recommended to support overall health and healing.
  8. Antiemetics: Medications to alleviate nausea and vomiting.
  9. Antidepressants: Antidepressant medications may be prescribed to manage depression or anxiety symptoms.
  10. Antibacterial Ointments: Topical antibacterial ointments or creams may be used to prevent secondary infections.


  1. Debridement: Surgical removal of infected or damaged tissue.
  2. Abscess Drainage: Drainage of abscesses or collections of pus.
  3. Synovectomy: Surgical removal of the synovial membrane surrounding the affected tendon sheath.
  4. Tendon Repair: Surgical repair of damaged tendons.
  5. Joint Replacement: In severe cases of joint destruction, joint replacement surgery may be necessary.
  6. Lymph Node Dissection: Surgical removal of affected lymph nodes.
  7. Soft Tissue Reconstruction: Surgical reconstruction of damaged soft tissues.
  8. Arthroscopy: Minimally invasive surgery to visualize and treat joint abnormalities.
  9. Nerve Decompression: Surgical decompression of compressed nerves.
  10. Bone Grafting: Surgical placement of bone grafts to repair bone defects.


  1. Vaccination: Getting vaccinated against tuberculosis can help prevent infection.
  2. Infection Control Measures: Practicing good hygiene, such as washing hands frequently and covering the mouth and nose when coughing or sneezing.
  3. Avoiding Close Contact: Avoiding close contact with individuals who have active tuberculosis.
  4. Screening and Testing: Screening for tuberculosis infection in high-risk populations and promptly treating active cases.
  5. Treatment Adherence: Adhering to tuberculosis treatment regimens as prescribed by healthcare providers.
  6. Ventilation: Ensuring proper ventilation in indoor spaces to reduce the risk of tuberculosis transmission.
  7. Education: Educating individuals about the signs, symptoms, and transmission of tuberculosis.
  8. Nutrition: Maintaining a healthy diet to support immune function and overall health.
  9. Quarantine: Isolating individuals with active tuberculosis until they are no longer contagious.
  10. Safe Injection Practices: Avoiding sharing needles or other injection equipment.

When to See a Doctor:

It is important to seek medical attention if you experience any of the following symptoms:

  • Persistent pain, swelling, or stiffness in a joint or tendon sheath.
  • Fever, night sweats, or unexplained weight loss.
  • Difficulty moving a joint or performing daily activities.
  • Redness, warmth, or tenderness around a joint.
  • Any other concerning symptoms that may indicate a possible infection or inflammation.

In conclusion, tuberculosis of tendon sheath is a serious condition that requires prompt medical attention. By understanding the causes, symptoms, diagnosis, treatment options, and prevention strategies outlined in this article, individuals can take proactive steps to protect their health and well-being. If you suspect you may have tuberculosis of tendon sheath or are experiencing any concerning symptoms, consult with a healthcare provider for proper evaluation and management.


Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. Thank you for giving your valuable time to read the article.