Atypical Presentation of Primary Greater Trochanter Tuberculosis - A Case Report

Tuberculosis (TB) of the greater trochanter constitutes about 2% of musculoskeletal TB cases, often presenting with non-specific symptoms of localized pain, tenderness, and swelling, necessitating differentiation from other conditions like tumors. Bursal involvement results in the formation of a fluctuating mass. This case emphasizes the need for meticulous diagnostic evaluation in these cases due to their uncommon presentation and potential for inadequate assessment.

A 50-year-old male experienced hip pain and swelling after a trivial fall, leading to surgery for suspected abscess. Despite initial treatment, symptoms persisted which on further imaging suggested TB osteomyelitis that was confirmed on biopsy, prompting 18 months of anti-tubercular therapy. The patient showed significant improvement after a year, highlighting the importance of thorough evaluation and appropriate management in such cases.

This case emphasizes the rare occurrence of primary TB in the greater trochanter, advocating for precise diagnosis through advanced imaging. It also underscores the importance of comprehensive TB testing, particularly in extrapulmonary cases which are prevalent in developing nations, to improve treatment outcomes.