Surgical management of scapular osteomyelitis with secondary septic arthritis of the gleno-humeral joint in a 12 year old boy: A case report.

INTRODUCTION AND

IMPORTANCE

Acute scapular osteomyelitis is an exceptional entity with a misleading clinical presentation. If not urgently diagnosed and treated correctly, it may lead to articular surfaces damage, deformation of the humeral head, and humerus shortening.

CASE PRESENTATION: A 12-year-old boy without any medical history with osteomyelitis of the scapular neck complicated with secondary septic arthritis of the gleno-humeral joint was evaluated. Through a posterior surgical approach, a large washout and articular drainage were performed. In the last follow-up visit 18 months later, the functional result was satisfactory: complete loss of pain, good shoulder mobility, and no anatomical anomalies were noted.

CLINICAL DISCUSSION: The most frequent site of hematogenous acute osteomyelitis is the long bones' metaphysis. Flat and short bones are rarely involved. The delayed diagnosis can be explained by unusual clinical presentation, so clinicians should point their reflections towards this particular entity because an early diagnosis as well as early treatment is crucial in order to achieve a satisfactory anatomical and functional result. Late diagnosis can be the cause of articular surface damage, and the involvement of the proximal humerus may lead to deformation of the humeral head. Early diagnosis and urgent treatment are the key combination for a satisfying outcome.

CONCLUSION

Acute osteomyelitis of the scapula requires specific surgical management to avoid any further complications, especially in children. We call attention to the importance of both urgent medical and surgical treatment for a better functional and anatomical outcome.