Tuberculous arthritis—the challenges and opportunities: observations from a tertiary center

Tuberculosis (TB) arthritis accounts for approximately 1–3% of all cases of tuberculosis and for approximately 10–11 % of extrapulmonary cases. The most common presentation is chronic monoarthritis. The Poncet's disease is a reactive symmetric form of polyarthritis that affects persons with visceral or disseminated TB. TB arthritis primarily involves the large weight-bearing joints, in particular the hips, knees, and ankles, and occasionally involves smaller nonweight-bearing joints. The diagnosis of TB arthritis is often delayed due to lack of awareness, insidious onset, lack of characteristic early radiographie findings and often lack of constitutional or pulmonary involvement. A high index of suspicion is necessary, especially in the context of persistent monoarthritis and synovial biopsy and prompt anti-tubercular therapy with adequate doses and duration prevents joint damage and preserves joint function. Surgical procedures should be restricted to joints with severe cartilage destruction, large abscesses, joint deformity or atypical mycobacteria.