Tuberculous arthritis of the hip with Staphylococcus aureus superinfection

A Subacute Presentation of Isolated Tuberculous Septic Hip Arthritis

Tuberculous septic arthritis is a rare type of septic arthritis that is caused by Mycobacterium tuberculosis. However, it can lead to devastating complications if not diagnosed and treated correctly. We hereby report a 41-year-old female with no medical history who presented with a three-week history of right hip pain and inability to bear weight, found to have moderate to severe tenderness at the right anterior hip and gluteal area and limitation of joint movement. Magnetic resonance imaging (MRI) of the hip showed features of right hip septic arthritis with synovitis and anteromedial and posteromedial small collections. She was diagnosed with tuberculosis (TB) after joint fluid aspiration, and she was started on anti-TB treatment including isoniazid, rifampicin, ethambutol, and pyrazinamide directly after. Considering the case and the subacute presentation that can mimic bacterial septic arthritis, clinicians should always consider TB infection in their differential diagnosis upon assessing a suspected patient with septic arthritis even with a subacute presentation to achieve the correct diagnosis and start appropriate treatment to avoid its harmful complications.