Bone tuberculosis is mainly caused by inhaling or swallowing Mycobacterium tuberculosis or bovine tuberculosis bacilli, and then it can be caused by lymphatic dissemination, hematogenous dissemination, and direct dissemination to adjacent tissues and organs. Bone tuberculosis is categorized into simple bone tuberculosis and granulomatous tuberculosis according to the clinical manifestations. Systemic symptoms include fever, chills, and coughing up shirts, accompanied by pleuritic pain, weight loss, and malaise. Patients may present with acute or chronic symptoms. The most common site of development of TB is the spine, especially in the elderly; however, it is also common in children and adolescents in developing countries. In some patients, primary TB foci are found in the lungs or urinary tract, while in others, no primary foci can be found. Lymphatic and hematogenous dissemination of TB usually occurs in the thoracolumbar region and rarely to the cervical spine and sacrum. Active lesions of spinal tuberculosis disrupt specific vertebral segments: usually two adjacent vertebrae and the intervertebral discs between them. Some investigators have hypothesized that the reason for this feature of lesion destruction is that the site has a rich arterial and venous blood supply, and Mycobacterium tuberculosis requires a high partial pressure of oxygen. About 80% of patients have periinterstitial disc lesions that invade the anterior portion of the vertebral body and eventually progress through the subligamentous space (anterior longitudinal ligament) to the adjacent vertebral body. In a minority of patients, the lesion occurs in the center of the vertebral body, which can resemble a tumor or cause a significant spinal deformity that is sometimes difficult to diagnose. Patients may have intramedullary granulomas, arachnoiditis, anterior wedge changes formed by segmental collapse of the vertebrae, and hunchback (Pott's disease). Tuberculosis of the posterior spinal structures alone is rare. Sometimes paravertebral abscesses form and form cutaneous sinus tracts that invade abdominal organs in the same plane. Paravertebral abscesses can reach as far as the ? fossa. The patient experiences pain, weakness, and in advanced cases paraplegia. Tuberculosis of the joints of the extremities mainly involves the large weight-bearing joints of the lower extremities. The lesion invades the articular cartilage and eventually granulomatous tissue forms that strips the cartilage. Invasion of the trabecular bone of the subchondral bone affects the weight-bearing function of the joint, which significantly accelerates the degeneration of the articular surface. Pathologic examination reveals necrotic tissue and multinucleated giant cells in the central area of the lesion. Other less commonly affected joints include the ankle, foot, and upper extremity joints. Patients may have a limp, and joints may show increased skin temperature, swelling, and decreased range of motion. TB of the joints can severely affect joint function, and even with aggressive and correct treatment, the lesion may recur in an isolated area. Tuberculosis of small peripheral joints is sometimes confused with other rheumatic diseases (e.g. gout and rheumatoid arthritis).