Four cases of purulent arthritis of the shoulder secondary to hematogenous osteomyelitis

In 4 cases of acute hematogenous osteomyelitis, the purulent process had penetrated the cortical bone to or lateral to the groove of the long biceps tendon. In 3 of the cases the process had spread along the tendon to the shoulder joint. In 1 case the periosteum was still intact, and the shoulder joint was not involved. The osteomyelitic focus should be reamed out until normal cancellous bone is reached. Suction irrigation drainage of the osseous cavity is recommended instead of the placement of gentamicin beads.