Tuberculous arthritis of the shoulder: delayed diagnosis aided by arthrography

Tuberculous arthritis of the shoulder was not diagnosed in an 80-year-old man with Addison's disease until the appearance of a draining abscess in his arm. Initially signs, symptoms, x-rays and laboratory studies were consistent with calcific tendonitis and degenerative arthritis. Then an arthrogram demonstrated a connection between the shoulder joint and the abscess. A high level of suspicion for tuberculous arthritis should be maintained in an elderly patient whose past medical history is suspicious for tuberculosis and whose articular complaints are chronic.