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Tuberculosis of knee joint and tubercular pyomyositis of gastrocnemius muscle.

Extra-spinal musculoskeletal tuberculosis (TB) is rare and tubercular pyomyositis is extremely rare. Tuberculosis of the knee-joint is a haematogenous infection secondary to a focus of active disease elsewhere in the body which may not be found. Tubercular pyomyositis usually caused by invasion from the adjacent structures rather than a secondary spread. Here we describe a 40 years old male patient who presented to us with pain in the right knee joint for one and half years and pain and swelling of right calf muscle for fifteen days. He was eventually diagnosed as a case of tuberculosis of the right knee joint and tubercular pyomyositis of right gastrocnemius muscle on the basis of fine needle aspiration from the right calf that showed caseation necrosis with clusters of epithelial cells despite absence of systemic symptoms, the absence of other foci of active tuberculosis and a normal chest radiograph.