|Articular disease often starts as a synovitis progressing to periarticular demineralization, marginal erosions, and finally joint destruction. The time period from synovitis to joint destruction can be rapid, particularly in weight-bearing joints. When tubercular arthritis complicated by secondary infection like Staphylococcus aureus presents, it results in accelerated joint destruction associated with severe systemic features. Joint tissue necrosis secondary to other disease such as osteonecrotic joints, due to sickle cell disease and chondrocalcinosis may predispose to tubercular infection. Before the advent of effective anti-TB chemotherapy, TB tenosynovitis and septic arthritis due to mycobacterial infections are now less common. The immunocompromised individuals, elderly or children in close contact to TB or patient who under treatment with corticosteroid and/or immunosuppressive and biologic agent or history of trauma should undergo microbiological or histological tests for TB which remains the gold standard in the diagnosis of TB.