A joint flare-up of systemic scleroderma revealing an unusual form of tuberculosis of the shoulder and extensor tendons

Tuberculosis remains a major concern, particularly in countries where it remains endemic. Tuberculous bursitis and tenosynovitis are rare localisations of this infection, and the association between tuberculosis and scleroderma is rarely described in the literature. We report the case of a 61-year-old patient with systemic scleroderma complicated by diffuse interstitial pneumonitis (DIP) on mycophenolate mofetil (MMP), presenting with arthritis and bursitis of the shoulder associated with tenosynovitis of the wrist extensors, both of tuberculous origin. The diagnosis was confirmed by ultrasound-guided puncture of the subacromial-deltoid bursa (SAD), revealing a high presence of acid-fast bacilli (AFB).