# Delayed Diagnosis of Tuberculous Coxitis in a Child Initially Misdiagnosed as Septic Arthritis: A Case Report

## TL;DR

A child with hip pain was misdiagnosed with septic arthritis for seven months before being correctly diagnosed with tuberculosis in the hip joint.

## Contribution

This case highlights the diagnostic challenges of tuberculous coxitis and emphasizes the need for early suspicion in chronic joint conditions.

## Key findings

- Delayed diagnosis of tuberculous coxitis led to joint destruction and deformity.
- Molecular testing confirmed Mycobacterium tuberculosis in gastric aspirate and joint pus.
- Multidisciplinary treatment with anti-TB therapy and surgery improved mobility and outcomes.

## Abstract

Tuberculous coxitis is a rare form of extrapulmonary tuberculosis in children, often misdiagnosed due to its subtle presentation and resemblance to other joint disorders. We report the case of a 12‐year‐old boy with a seven‐month history of progressive right hip pain, joint deformity, and a draining sinus, initially mismanaged as a nonspecific infection. Imaging revealed destructive changes in the right hip, and molecular testing confirmed
Mycobacterium tuberculosis
from both gastric aspirate and intra‐articular pus. The patient underwent anti‐tuberculosis therapy and surgical debridement with internal fixation. Histopathology confirmed tuberculous arthritis. Significant clinical improvement was observed postoperatively, with restoration of mobility. This case underscores the importance of early suspicion of skeletal TB in chronic monoarthritis, especially in endemic regions. Delayed diagnosis may lead to joint destruction and disability, but multidisciplinary management and timely intervention can yield favorable outcomes.

We report a paediatric case of tuberculous coxitis initially misdiagnosed as septic arthritis, resulting in delayed diagnosis and joint destruction. Molecular testing confirmed
Mycobacterium tuberculosis
, and the patient underwent anti‐TB therapy and surgical intervention. Early recognition and multidisciplinary management are essential to prevent disability in skeletal TB.