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An improper diagnosis may be due to atypical clinical presentation, wide use of antibiotics, the low specificity of diagnostic tools, and most of all, the clinician not prioritizing the possibility of tuberculous arthritis. Open biopsy and the result of the microbial culture establish the definitive diagnosis of knee tuberculosis. In conclusion, the clinical and radiologic findings in TB gonitis and PVNS are occasionally similar. Therefore TB gonitis should be highly suspicious, especially in endemic areas. Histopathology result