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Tuberculosis is a major health problem in India and in view of rise in the MDR tuberculosis atypical presentations are getting commoner these days and are difficult to diagnose. Musculoskeletal tuberculosis is very common among the  hematogenous spread cases of pulmonary tuberculosis involving thoracic spine the most. Involvement of sacrum and coccyx is rarest of  the possibility and isolated sacrococcygeal tuberculosis thus is very rare. Being a rare entity a high index of clinical suspicion is required to diagnose it. We hereby report a very rare case report of sacrococcygeal tuberculosis.

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