Abstract
Background: Although tuberculosis (TB) can affect any organ, ruptured Baker's cyst due to TB is an uncommon phenomenon. Case Summary: A young lady presented with unilateral atraumatic knee and calf pain and swelling. Pain characteristics shared both mechanical and inflammatory natures. Constitutional features for TB were evident. Based on history, clinical examination, and initial investigation, a ruptured Baker's cyst with septic knee was suspected. Ultrasound-guided aspiration followed by a synovial fluid study revealed inflammatory fluid with high adenosine deaminase level but without any bacterial growth in culture and negative GRAM and AFB staining. Empirical therapy was not curative. Commencement of anti-TB brought better clinicopathological outcome. Customized rehabilitation was set up. Conclusion: Unilateral monoarthritis with ruptured tubercular Baker's cyst is a rare condition. Diagnosis, drug management, rehabilitation, follow-up, and recurrence prevention are challenging; especially with low resources. We took initiatives to collaborate all these.