TB arthritis is most commonly monoarticular and of insidious onset. It is commonly presented with chronic joint paint and only minimum sign of inflammation. Most common symptom is local pain and swelling followed by restriction of movement of the affected area. There is wasting of the regional muscle and deformity may occur. Less commonly, painless cold abscess was the only clinical presentation. Involvement of multiple sites is seen in 5-30% cases of tubercular arthritis. Reactivation of tubercular arthritis after treatment occurs in 17-34% of individuals. Reactivation most commonly occurs in hip joint. Joints swelling and evidence of effusion, periarticular abscess and chronic sinus formation occur late. Multiple joint involvements has been reported. Systemic symptoms of fever, weight loss, and night sweat may or may not be present during active TB arthritis. Less than 50% of individuals with tubercular arthritis have active pulmonary TB at the time of diagnosis.