Tuberculosis hip case

1. Case 9

2. History
16 year boy has a history of pain in his left hip for last 6
Months. He was initially seen in a local hospital 6 months
back when he had complained of fever off and on with
pain in his groin. According to the patient he was
prescribed some medications and was advised a rest after
which he improved. Over this period he has pain in his hip
off and on and now he is not able to bear weight on left
side.

3. Examination
The left lower limb is in an attitude of Flexion, adduction and
Internal rotation.
All movements are restricted
There is apparent shortening with a true shortening of 1.5 cm which
was mainly in Supra trochanteric region

4. Thomas test reveals that there is an element of Fixed
flexion deformity and patients walks with a
trendenlenburg’s gait.

5. Labs
Increased ESR
Positive CRP
Relative Lymphocytosis with normal
WBC count

6. ‘TBHIP’

7. Diagnosis
Management