Abstract
Tuberculosis remains a global health concern, with children at higher risk of extrapulmonary involvement. An 8-year-old immunocompetent Eritrean girl in Belgium presented with painful ankle swelling. Imaging showed osteomyelitis and systemic calcifications. Mycobacterium tuberculosis was isolated from surgical drainage. She was diagnosed with osteomyelitis and scrofuloderma in the context of miliary tuberculosis, though a metastatic abscess could not be excluded. Tuberculosis should be considered in children from endemic regions presenting with persistent osteoarticular or cutaneous lesions to ensure early diagnosis and prevent complications.