Refusal to Carry Backpack to School: Early Lumbar Tuberculosisina Six Year Old

The infective pathologies with insidious onset like tuberculosis affecting the spine in a paediatric age group requires high index of suspicion. It has varied presentations and generally not diagnosed till secondary deformities start to appear. Owing to the fact that standard clinical examination is not feasible in young children, onus lies on keen observation to suspect and detect underlying sinister lesion. The presented case underlines importance of careful attention to child's complaints and recent change in behaviour as pointer toward an unexpected outcome.