Water melon seed bodies in wrist? An unusual and rare case of tuberculous arthritis with water melon seed bodies

Deesha Narendra Bhemat*, Mallinath Basalingappa Hoogar, Reeta Dhar, Atul Jain, Avni Gupta, Vaidehee Naik, Avani Jain, Urshlla Kaul


Tuberculosis primarily affects lungs, though involvement of extra-pulmonary sites is on a relative rise in the backdrop of increased incidence of immune compromised disorders such as HIV/AIDS. The extra-pulmonary sites which are most commonly involved are lymph nodes, genitourinary tract, bone marrow, CNS and musculoskeletal system. Tuberculosis of musculoskeletal system includes bones, joint, bursas and tendons or tenosynovium, the incidence of which is rare. Though tuberculosis involves various parts of musculoskeletal system, involvement of wrist and hand is quite rare. Since the involvement of joints of wrists by tuberculosis is very uncommon. Early diagnosis of tuberculosis of wrist is often difficult, in as much as clinical manifestations of other arthritides mimic tuberculous tenosynovitis. Many times, operative findings of melon seed bodies are characteristically suggestive of tuberculosis. The case being presented here is unique and unusual one, which characteristically presented with intraoperative finding of numerous water melon seed which are considered in literature to be helpful in diagnosis of tuberculous arthritis.


Tuberculosis; Arthritis; Watermelon seed bodies; Rice bodies; Tuberculous tenosynovitis

Full Text:



Dr Mario Raviglione et al., “Global Tuberculosis Report 2015” World Health Organization 2 (2015): 8.

Daya Krishna, R.S Bisht, Vikas Sikarwar, Shubash Chand. “Compound Palmar Ganglion: A Case Report”. IOSR Journal of Pharmacy 2.6 (2012): 20-22.

Hitesh Lall, Suman Kumar Nag, Vijay Kumar Jain, Rahul Khare, Deepak Mittal. “Tuberculous extensor tenosynovitis of the wrist with extensor pollicis longus rupture: a case report”. J Med Case Reports 3 (2009): 142.

Arun Kumar K, Kanthimathi B, Krishnamurthy CS, Sujai S. “Compound palmar ganglion: A tubercular manifestation of flexor tenosynovitis of the wrist”. International Journal of Case Reports and Images 3.2 (2012): 28-31.

Kemal GÖKKUŞ, Ergin SAĞTAŞ, Ahmet Turan AYDIN. “Tuberculous Tenosynovitis of the Wrist Mimicking a Volar Wrist Ganglion Cyst and Carpal Tunnel Syndrome”. Archives of Rheumatology 28.2 (2013): 128-131.

Serkan Bayram, Ali Erşen, Murat Altan, and Hayati Durmaz. “Tuberculosis tenosynovitis with multiple rice bodies of the flexor tendons in the wrist: A case report”. Int J Surg Case Rep. 27 (2016): 129–132.

Seung Eun Hong, Ji-Hyun Pak, Hyun Suk Suh, So-Ra Kang, and Bo Young Park. “Rice Body Tenosynovitis without Tuberculosis Infection after Multiple Acupuncture Procedures in a Hand”. Arch Plast Surg 42.4 (2015): 502–505.

C.Y. Woon, E.S. Phoon, J.Y. Lee, M.E. Puhaindran, Y.P. Peng, L.C. Teoh. “Rice bodies, millet seeds, and melon seeds in tuberculous tenosynovitis of the hand and wrist”. Ann. Plast. Surg 66 (2011): 610–617.

Ravikumar K, Nishanth A, Nanjundappa H.C. “Tuberculous tenosynovitis of both flexor and extensor tendons at wrist with carpal involvement”. Int J Health Sci Res. 5.5 (2015): 558-561.

Santosh Somayya Jeevannavar, Prasanna Baindoor. “Rice bodies in the knee: classic tuberculosis of the knee”. BMJ Case Reports 17 (2014); doi: 10.1136/bcr-2013-202975

Pimprikar MV, Kekatpure AL. “Subdeltoid Bursa Tuberculosis with Rice bodies formation: Case Report and Review of literature”. Journal of Orthopaedic Case Reports 4.2 (2014): 57-59.

Vaish A, Sancheti P, Vaishya R, Shyam A. “An Unusual Case of Acl Cyst with Multiple Melon Seed Bodies of the Knee”. Journal of Orthopaedic Case Reports 6.1 (2016): 14-16.

Hiroyuki nagasawa, Kyoji Okada1, Seietsu Senma, Shuichi Chida andYoichi shimada. “Tenosynovitis with rice body formation in a non-tuberculosis patient: A case report”. Upsala journal of medical sciences 114 (2009): 184-188.

DOI: http://dx.doi.org/10.21746/ijbio.2017.02.002


  • There are currently no refbacks.

Copyright (c) 2017 International Journal of Bioassays

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

International Journal of Bioassays is a member of the Publishers International Linking Association, Inc. (PILA), CROSSREF and CROSSMARK (USA). Digital Object Identifier (DOI) will be assigned to all its published content.