Overcoming Challenges in Pediatric Hip Joint Tuberculosis: A Case Report Highlighting the Impact of Sampling Technique and Resource Limitations

evening rise, for the last 2 months.There was no history of trauma, morning stiffness, swelling or pain in any other joint, skin rash, bowel or urinary symptoms, any neurological deficit, steroid use, productive cough, or any other respiratory symptoms.The patient had previously visited a local doctor in her area, who had started her on antibiotics for her complaints and suggested magnetic resonance imaging (MRI) hip and referred her to us for any further management. IntroductIonSkeletal tuberculosis (TB) is a significant health concern, and the timely identification of clinical features, sampling, diagnostics, and management of such cases is crucial to control the disease burden, especially in countries like India where the majority of health care is working with limited resources and socioeconomic burdens. 1 The pediatric skeletal TB can often mimic other orthopedic conditions such as juvenile idiopathic arthritis, septic arthritis, or trauma-related disorders, often leading to delayed diagnosis and inappropriate treatment.2 GeneXpert Mycobacterium tuberculosis/rifampicin (MTB/RIF), a widely used rapid molecular diagnostic tool endorsed by the World Health Organization (WHO), has revolutionized TB diagnosis, but its accuracy depends heavily on the quality of the sample collected, something often compromised in resource-limited rural settings.3 This report presents a case of a young female child from a lowincome rural region of Rajasthan who was initially misdiagnosed due to a false-negative GeneXpert MTB/RIF result, likely stemming from improper sampling. case descrIptIonA 10-year-old female patient, resident of Bhilwara, Rajasthan, presented to the pediatrics outpatient department (OPD) of our tertiary care hospital with the complaints of difficulty in walking for the last 2 months.This symptom was insidious in onset, progressive in nature, and associated with moderate pain in the right hip joint.The patient also had high-grade fever, with