As the incidence of tuberculosis in Japan decreases, osteoarticular tuberculosis becomes relatively rare. Therefore, it is often overlooked or misdiagnosed that leads to cryptic aggravation of the disease. On the other hand, because of population aging in Japan, degenerative conditions such as compression vertebral fracture or osteoarthritis should be considered as differential diagnoses of osteoarticular tuberculosis. In addition, we should beware of extra-pulmonary tuberculosis in the patients who undergo biological agent therapy for rheumatoid arthritis that has been advanced drastically in recent years. Surgical treatment for osteoarticular tuberculosis is still an essential part of its treatment in order to achieve early rehabilitation and rapid healing of the lesion.