Tuberculous arthritis in the course of connective tissue disease: report of 4 cases

We describe 4 female patients with diverse connective tissue diseases who developed tuberculous arthritis concurrently with their underlying disease, in the absence of lung involvement. Throughout, diagnosis was delayed but later confirmed by detection of Mycobacterium tuberculosis in synovial membrane culture. Two patients died of unrelated causes, while the other 2 recovered with chronic joint sequelae. Despite the rarity of this association, M. tuberculosis infection should be considered in the differential diagnosis of chronic mono or oligoarthritis in patients with connective tissue diseases.