Musculoskeletal tuberculosis is the commonest form of extrapulmonary tuberculosis however Rib lesion is uncommon and occurs in zero to five percent of bone and joint tuberculosis. In our case report both chest X ray and CT were useful in demonstrating the skeletal lesion and also in the assessment of response to treatment, as follow up chest X ray and CT scan at 4 months and after 12 months of anti tubercular drugs showed remarkable new bone formation and clearing of pleura parenchymal lesions.