Introduction: One of the infectious causes of wrist tenosynovitis is Mycobacterium tuberculosis. Tendon sheath involvement is rare. Herein, we report the diagnosis and treatment of a patient with neglected wrist flexor tendon sheath tuberculosis. Presentation of case: We report the diagnosis and treatment of a man aged 50 years with neglected wrist flexor tendon sheath tuberculosis. Discussion: In patients with tendon sheath involvement, symptoms are generally non-specific such as pain and swelling; therefore, it can be diagnosed late due to the lack of systemic symptoms. Wrist X-ray imaging in tenosynovitis may show soft tissue swelling and osteoporotic changes around the wrist joint. T2-weighted sequences in magnetic resonance imaging are more successful in supporting the diagnosis. Conclusion: M. tuberculosis should be kept in mind as an infectious agent, especially in developing countries. In order to prevent any delay in diagnostic evaluation, all steps should be taken carefully.
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