Osteomyelitis of scapula with secondary septic arthritis of shoulder joint in a six month old child.

Sanjay Meena,Mohammed Tahir Ansari

doi:10.5704/moj.1303.001

Abstract

We report a case of delayed diagnosis of osteomyelitis of the scapula extending to glenoid, with secondary septic arthritis of glenohumeral joint in a 6-month-old female infant. We performed urgent arthrotomy of the shoulder joint through an anterior approach with drainage of pus from the scapula through a posterior approach and prescribed intravenous antibiotics. Diagnosis was delayed as the patient initially presented with pneumonia, for which she was treated in the neonatal intensive care unit; at that time, all medical efforts were directed toward saving her life. Had the diagnosis been made earlier, septic arthritis of the shoulder might have been prevented. Diagnosis of septic shoulder arthritis is rare and difficult, requiring a high index of suspicion. septic arthritis, infection, scapular osteomyelitis.

Highlights

Osteomyelitis of the scapula is a rare clinical entity[1]
We report a case of delayed diagnosis of scapular osteomyelitis in a 7-month-old female infant, which initially involved the inferior angle of the scapula, extending up to the glenoid
Acute septic arthritis results from bacterial invasion of a joint space, which can occur through haematogenous spread, direct inoculation from trauma or surgery, or contiguous spread from an adjacent site of osteomyelitis or cellulitis

Summary

INTRODUCTION

Osteomyelitis of the scapula is a rare clinical entity[1]. Acute septic arthritis of the shoulder in children typically occurs as a complication of osteomyelitis of the proximal humeral metaphysis[2]. We report a case of delayed diagnosis of scapular osteomyelitis in a 7-month-old female infant, which initially involved the inferior angle of the scapula, extending up to the glenoid. Osteomyelitis extended to the entire scapula and extended to glenohumeral joint causing secondary septic arthritis of the joint. The diagnosis of septic shoulder is uncommon and difficult, and requires a high index of suspicion 3

CASE REPORT

DISCUSSION

Scapula Osteomyelitis with Secondary Septic Arthritis