The frequency of tuberculosis in organ transplant recipients has not been clearly determined and varies according to geographical distribution. However, the incidence has been considerably higher in organ transplant recipients than in the healthy population. Tuberculosis may have an atypical presentation in immunocompromised hosts, which can delay the diagnosis. Also, tuberculosis leads to alteration in immunosuppressive treatments, such as drug interaction or discontinuation. In this case, we present a kidney transplant recipient with joint pain in the right hand and wrist. Her pain was refractory to analgesics and steroid therapy. Tenosynovitis was detected by radiological examination. Subsequently, miliary tuberculosis diagnosis was established through the onset of respiratory symptoms during hospitalization. The diagnosis was based on thoracic tomographic findings and molecular tests. The arthralgias resolved after the administration of tuberculosis therapy.