Acute hematogenous osteomyelitis of the scapula in children

Osteomyelitis of the scapula is uncommon, often with a misleading clinical presentation. We report four cases of osteomyelitis of the scapula to illustrate the particular clinical imaging findings and treatment related to this location.

Between 1996 and 2006, four children were treated for osteomyelitis of the scapula, three boys and one girl, with a mean age of 8 years (range, 5-11 years). The time from symptom onset to hospitalization was 2 days. Pain was noted for all patients and total functional incapacity of the upper extremity was noted for three patients. The diagnosis of osteomyelitis of the scapula was established on the basis of imaging (ultrasound and CT scan). All patients were given medical treatment and underwent surgery. A positive bacteriology was noted in all patients. The bacterium isolated from blood cultures (two cases) and local samples obtained at the surgical site (four cases) were Meti-S Staphylococcus aureus.

The results were analyzed by studying the anatomic and functional outcome at a mean follow-up of 36 months (range, 16-60 months). The patients were pain-free and had full range of motion in their shoulders. There were no complications.

Few reports are available in the literature on osteomyelitis of the scapula. We discuss the specific clinical and imaging features as well as the treatment for this location.