Abstract Rifampicin resistant Mycobacterium Tuberculosis (TB) is common but extrapulmonary Rifampicin resistant Mycobacterium TB of the elbow joint is very rare. We present a 45 year old male patient who presented with a one week history of worsening pain, swelling and decreased range of motion of the left elbow joint. He underwent incision and drainage where GeneXpert revealed Rifampicin re- sistant mycobacterium TB complex and Rifampicin resistant anti-TB treatment was started. The patient had good outcomes; clinical symptoms had resolved, septic markers were within normal limits and radiologically had intra-articular joint involvement without gross destruction. Volume 2 • Issue 1 • 2020 Copyright © All rights are reserved by CS Nkosi. Journal of Orthopaedic and Trauma Care Case Report Collen Sandile Nkosi 1 *, Maxwell Jingo 2 and Mmampapatla Thomas Ramokgopa 3 1 MBChB (UL), Orthopaedic Registrar, University of the Witwatersrand, Johannesburg, South Africa 2 PhD (wits), Senior Research Coordinator, Orthopaedic Department, University of the Witwatersrand, Johannesburg, South Africa 3 FCS (Orth) SA, MBChB (UKZN), Head of Orthopaedic Department, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, South Africa Received: September 11, 2020; Published: September 18, 2020 *Corresponding Author: Dr, CS Nkosi, Orthopaedic surgery, Chris Hani Baragwanath Academic Hospital, 26 Chris Hani Rd, Diepkloof 319-Iq, Johannesburg 1864, South Africa. Email id: drcsnkosi@gmail.com A Rare Case Report of Extrapulmonary Rifampicin Resistant Mycobacterium Tuberculosis of the elbow Joint Citation: Collen Sandile Nkosi, Maxwell Jingo and Mmampapatla Thomas Ramokgopa. (2020). A Rare Case Report of Extrapulmonary Rifampicin Resistant Mycobacterium Tuberculosis of the elbow Joint. Journal of Orthopaedic and Trauma Care 2(1). Introduction Extrapulmonary Tuberculosis (TB) is an airborne disease caused by the bacterium mycobacterium TB within the body other than the lungs. This disease contributes about 15-20% of all cases in patients who are immunocompetent and 70% in patients who are human immunodeficiency virus (HIV) positive (1). The disease presents mostly in patients who are immunosuppressed and HIV positive with a CD4 cell counts < 250 cells/mm 3 (2). Musculoskel- etal TB is rare and accounts for 1-3% of all TB cases. The spine has the commonest musculoskeletal involvement at 51% (3,4). TB ar- thritis of the elbow constitutes 2 ‒ 5% of all musculoskeletal TB (4). South Africa (SA) has the highest burden of Rifampicin resistant TB and treats the third largest number of cases internationally after Keywords: Rifampicin resistant; Tuberculosis; Elbow joint; Extrapulmonary Tuberculosis Abbreviations: CD4: Cluster Diferentiation 4; HIV: Human immunodeficiency virus; SA: South Africa; TB: Tuberculosis; UA: uric acid; ESR: Erythrocyte Sedimentation Rate; CRP: C Reactive Protein; WCC: White blood Cell Count; MRI: Magnetic resonance imaging; PCR: Polymerase chain reaction Level of evidence: Level 4