Destructive tuberculous osteoarthritis of the shoulder in the elderly

Osteoarthritis (OA) due to tuberculosis (TB) is rare. The usual sites are the spine and weight-bearing joints, while joints such as the shoulder are less often affected. In recent years there has been a resurgence of TB, the rate of increase of extrapulmonary surpassing that of pulmonary TB. The elderly, especially residents of nursing homes, are at increased risk for active TB. The course of the disease is characterized by insidious development, and systemic involvement is usually not noted. Months or even years may elapse before the correct diagnosis is made, sometimes only after irreversible damage. We present an 82-year-old woman with TB OA of the shoulder, illustrating the importance of this curable disease in the differential diagnosis of chronic monarthritis.