IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Acute osteomyelitis - humerus

Case contributed by Maulik S Patel
Diagnosis probable

Presentation

Right proximal arm and shoulder pain for the last two days.

Patient Data

Age: 10 years
Gender: Male
x-ray

There is no periosteal reaction/ bone lesion/ fracture/ dislocation. There is soft tissue swelling involving the shoulder and the proximal arm region.

ultrasound

There is subperiosteal fluid in the proximal humeral metaphysis region. There is no obvious cortical erosion. There is no effusion in the biceps tendon sheath. Rotator cuff was normal.

2nd US study 36 hours later

ultrasound

There is an additional finding of a non-compressible axillary vein with internal echoes. There was no color flow in the vein. The acompanying artery is patent.

Case Discussion

A child had the right shoulder and the proximal arm region swelling and pain. X-ray was negative for a periosteal reaction. Ultrasound showed subperiosteal fluid involving the proximal humerus. Follow up ultrasound revealed an additional finding of axillary venous thrombosis. Surgery confirmed the presence of subperiosteal pus. A pathology study showed staphylococcus aureus.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.