Abstract
Tuberculosis (TB) in the musculoskeletal system is rare, though it is an emerging health concern in many developing countries. Sacroiliac joint (SIJ) TB is uncommon. This report highlights the use of ultrasound-guided (USG) aspiration to diagnose SIJ TB. We report a 23-year-old boy who presented with low back pain and localized tenderness over the SIJ. Initial imaging showed signs of inflammation. USG aspiration was performed successfully to obtain fluid for microbiological analysis, and laboratory investigations confirmed the presence of Mycobacterium tuberculosis. Sacroiliac TB often presents in the absence of classic symptoms, and minimally invasive procedures like USG aspiration can play a role in providing rapid diagnosis and treatment. Early identification and appropriate management can prevent further complications and improve patient outcomes in regions where TB remains endemic in the world.