case_images: PMC10787524_01
case_images: Pre-operative image of left wrist showing swelling over the anterior aspect of the wrist (yellow arrow).
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case_images: A 67-year-old Sri Lankan male patient with a background of seropositive rheumatoid arthritis of 5 years presented with progressively enlarging left wrist swelling with pain and numbness of the left hand for 2 months duration (Figure 1).
case_images: T2 weighted magnetic resonance imaging scan of hand and distal forearm showing synovial thickening with cystic areas over the palmar aspect of hand extending through carpal tunnel into the forearm (a) sagittal section- red arrow, (b) axial section- yellow arrow.
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case_images: Magnetic resonance imaging scan of hand and distal forearm showed enhancing synovial thickening with cystic areas over the palmar aspect of the hand extending through carpal tunnel into the forearm without any bony involvement in the region (Figure 2).
case_images: Intraoperative images showing a mass related to flexor tendons (a, yellow arrow) and completely excised synovial mass (b, red arrow).
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case_images: Thickened synovial mass extended from mid palm to distal forearm, and complete excision was performed (Figure 3).
case_images: Histology showing Langhan-type giant cell in the background of granulomatous inflammation (a) power of 10-red arrow, (b) power of 40-yellow arrow.
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case_images: TB (Figure 4). The culture of the sample in Lowenstein Jensen culture medium with colony morphology and immunochromatographic identification test (MPT 64) was positive for Mycobacterium tuberculosis.
case_images: Post-operative images showing good range of motion at the end of 9 months.
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case_images: At the end of 1 year of follow-up, he was asymptomatic with good range of motion of fingers and improved sensory impairment (Figure 5).