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

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.