Scapular bone destruction: do not forget to think of tuberculosis in endemic areas

Abstract

Tuberculosis is an endemic disease of worldwide concern. The most common involvement is in the form of pulmonary tuberculosis. Musculoskeletal system is involved in 20-30% of cases of extrapulmonary tuberculosis. Among these cases of musculoskeletal tuberculosis, vertebral column is most commonly involved followed by long bones. However, tuberculosis of flat bones like scapula is very rare. We present a case of a 56-year-old woman with painless swelling in the right lower back of chest. Ultrasonography suggested abscess formation. A chest X-ray and CT scan suggested coexisting pulmonary tuberculosis. CT revealed abscess with osteomyelitis of inferior angle of scapula. The abscess was aspirated and histopathological examination confirmed tubercular pathology. A 6-month course of antitubercular treatment resulted in complete resolution of symptoms.

Primary Rifampicin Mono-Resistant Extrapulmonary Tuberculosis of the Scapula With Cold Abscesses: A Report of a Rare Case

“…Even a magnetic resonance imaging scan can be occasionally misleading [ 9 ]. Furthermore, solitary involvement is more common in adults, whereas multifocal involvement is more common in children [ 11 ].…”

Sonographic Features of a Tuberculous Cold Abscess: A Case Report and Literature Review

“…While the most common site of EPTB are lymph nodes, TB can infiltrate almost any part of the human body. Musculoskeletal involvement of EPTB accounts for 20–30% of EPTB cases, and vertebral bones remain the predominant site of infection 3 . Tuberculosis of chest wall is an uncommon form of osteoarticular tuberculosis and accounts for 1-5% of bone tuberculosis 4 .…”

Isolated tubercular osteomyelitis of acromion: A case report and review of literature

“…Lateral border of scapula 22/F ATT Asymptomatic Multifocal Greenhow et al 12 Inferior aspect 14/F Excision of mass Nontender mass, NA Stones et al 13 Scapula 42/M Expired Discharging sinus Multifocal Husen et al 14 Spine of scapula 18/M ATT Pain Isolated Srivastava et al 15 Inferior angle 26/F Aspiration and ATT Pain and Swelling Isolated Solav 16 Spine 5 Body of Scapula near glenoid 14/M ATT Pain, Discharging Sinus Isolated Singh et al 7 Inferior angle scapula 49/F Drainage, ATT Pain, Swelling Isolated Tripathy et al 6 Body of scapula 22/M ATT Pain, Swelling Isolated Jagtap et al 17 Inferior angle of scapula 25/M Drainage, ATT Pain, Swelling Isolated Sharma et al 18 Inferior angle of scapula 56/F ATT Swelling, No Pain Isolated ATT, anti-tubercular therapy.…”