| Summary: | ABSTRACT Tuberculosis (TB) remains a major public health challenge in Kenya. Though a multisystemic disease, some of the manifestations of tuberculosis such as Poncet's disease are rare and should be considered in patients presenting with symmetric polyarthritis in TB‐endemic areas. We present a case of a 49‐year‐old male patient who presented with sub‐acute ankle and foot swelling and was initially managed for osteoarthritis without improvement. At initial presentation, the history of constitutional features was equivocal, missing a potential opportunity to diagnose a systemic illness. On developing constitutional features of weight loss and fevers, a suspicion of tuberculosis was made, and a diagnosis of pulmonary tuberculosis confirmed on chest imaging and sputum Gene Xpert test. This case highlights the importance of maintaining a high index of suspicion when dealing with patients with polyarthritis.
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