Osteoarticular tuberculosis (TB) mimics and mimicked as well by other diseases very closely, i.e., tumors, chronic infections, fungal infections, parasitic infections, etc., which poses a great difficulty in early diagnosis and initiation of treatment. In our case report, the patient complains of dull aching pain and discharging sinus over the dorsum of the left foot with a lytic lesion in the base of the third metatarsal left foot on plain radiographs. We have started the patient on anti-tubercular therapy (ATT) based on high suspicion. Due to the non-resolution of the discharging sinus on multidrug ATT, an open biopsy was planned for the patient. Intraoperatively, a wooden foreign body was detected lying in the soft tissue around the lytic lesion of the third metatarsal base which was found to be a thorn retrospectively on further evaluation. Histopathological examination (HPE) of soft tissue suggestive of chronic osteomyelitis and culture showed growth of Pseudomonas spp. sensitive to ciprofloxacin. The patient improved clinical–radiological over the period of 3 weeks on a sensitive antibiotic (ciprofloxacin). All the cases with a suspected diagnosis of tuberculous osteomyelitis and associated lytic lesion in the foot bones should undergo open biopsy and culture evaluation.