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Tuberculosis of the scapula.

Yousuf A Husen1, Naila Nadeem, Fawad Aslam

  • 1Department of Radiology, Aga Khan University Hospital, Karachi.

JPMA. the Journal of the Pakistan Medical Association
|August 12, 2006
PubMed
Summary

Scapular tuberculosis (TB) is a rare bone infection. Increased Acquired Immunodeficiency Syndrome (AIDS) may lead to more frequent cases of this rare TB presentation.

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Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Radiology

Background:

  • Osteoarticular tuberculosis is uncommon, with scapular involvement being exceptionally rare.
  • Endemic tuberculosis settings, especially with rising Acquired Immunodeficiency Syndrome (AIDS) rates, may see an increase in rare TB presentations.
  • Early diagnosis is often missed due to non-specific symptoms.

Observation:

  • Patients typically present with prolonged shoulder pain and swelling, often affecting young adults.
  • Radiographic findings include well-defined radiolucent lesions with minimal bone fragmentation (sequesteration).
  • Elevated erythrocyte sedimentation rate (ESR) is a common laboratory finding.

Findings:

  • Scapular tuberculosis presents with insidious onset of pain and swelling.
  • Radiological hallmarks include lucent lesions and minimal sequestration.
  • Differential diagnosis requires a high index of clinical suspicion to avoid misdiagnosis.

Implications:

  • This case highlights the importance of considering tuberculosis in the differential diagnosis of shoulder pain, particularly in endemic areas.
  • Prompt medical therapy with antituberculous drugs is crucial for successful treatment.
  • Increased awareness is needed to improve early detection and management of this rare condition.

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