Tuberculosis of the knee is rare, but when it does occur, it is more frequent in children than adults.
The child often presents with pain in the knee, limping and restriction of movement. The affected knee seems small and globular, and the quadriceps muscles are wasted. Palpation reveals a warm joint with synovial thickening.
Radiological appearances vary with time. Early on, there is marked osteoporosis. In children, there is enlargement of the bony epiphyses. Later, the joint surfaces are eroded resulting in marked deformation.
Once separated from differentials such as monoarticular rheumatoid synovitis and juvenile chronic arthritis, antituberculous chemotherapy is instigated. Severe deformation of the joint can be treated by arthrodesis.
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