Osteoarticular (spinal and extra spinal) tuberculosis consist of1% to 5% of all cases of tuberculosis and 10% to 18% of EPTB. The diagnosis of osteoarticular tuberculosis is often delayed due to insidious onset, lack of constitutional and pulmonary involvement, lack of awareness, or due to lack of characteristic early radiographic findings. The purpose of this analysis is to provide an update on the diagnostic and therapeutic recommendations for osteoarticular TB. In this retrospective study, laboratory and hospital records were collected, evaluated and analyzed for all the patients with suspected osteoarticular TB. Data collection was done during the period of 3 years from 2017 to 2020, from the CBNAAT center, AIIMS Patna with suspected sample for confirmation of TB. Out of 62 suspected patients tested, 9 (14.52%) were detected positive by CB NAAT test for osteoarticular TB. Among these 9osteo-articularTB cases 4 (44.44%) were Rifampicin sensitive, 4 (44.44%) were Rifampicin resistant and 1 (11.11%) case was indeterminate for Rifampicin. 62suspects were identified having mean age at the presentation was33.72 years with age ranges from 4 to 71 years, male to female ratio was 1.8:1 (40:22). The manifestations were articular (arthritis or arthralgia in 54 cases, comprises as41were monoarthritis, 9 were oligoarthritis and 4 with polyarthralgia) followed by tenosynovitis (n=13) and tuberculous osteomyelitis (n=3). 2 patients were detected with disseminated TB. Most common clinical symptoms were pain (n=48), followed by swelling of the involved site (n=14). 27 (43.54%) patients presented with fever whereas previous history of TB was shown in8 patients. 13 (20.96%) patients were associated with concurrent pulmonary TB. 8 (12.9%) patients had lymph node enlargement. A definite diagnosis of osteoarticular TB was made in 9 (14.51%) patients and rest 53 (85.48%) are probable TB patients. Manifestations of osteoarticular TB occurs at any age but in this study most common age group affected were in between 10 to 30years.Tenosynovitis and/or oligoarthritis may be a presenting manifestation but chronic monoarthritis is the most common presentation. The diagnosis of osteoarticular TB should not be discourage in the absence of fever. This study makes aware about the burden of osteoarticular tuberculosis cases and higher risk of development of multidrug resistant (MDR) osteoarticular TB. Thus early diagnosis of MDR in osteoarticular TB and start of specific anti-tubercular therapy help into get an earlier and better outcome.

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