Osteoarticular tuberculosis, especially in the foot is uncommon.1 It makes up less than 3% of cases of extra-pulmonary tuberculosis. As such, it has remained a diagnostic enigma despite improvements in investigative technology.1–4 It is an aggressive disease. Any significant delay in diagnosis may lead to spread of the infection from bone into adjacent joints and surrounding soft tissue. This leads to significant functional disability.1,4 A 36-year-old South Indian priest attended the orthopaedic department with a 1-year history of spontaneous onset right foot pain. There was no history of trauma or any systemic symptoms that may indicate infection. By the time of presentation he had been living in the UK for over 5 years. His symptoms were affecting his work as a priest as footwear was not permitted in his temple. On examination there was …
