Isolated Tubercular Osteomyelitis of Scapula - A Report of Two Cases and Review of Literature.
BACKGROUND
Isolated tuberculosis of the scapula is rare. The presentation mimics the tumors of scapula. Hence it is important to know the clinical presentation and when to suspect tubercular osteomyelitis of scapula. Few cases have been described before. We have analyzed all reports with isolated scapular tuberculosis so far and described the varied presentations.


METHODS
We report two cases of isolated scapular tuberculosis. One patient underwent aspiration and was started on antituberculous drugs (ATT) and the other underwent debridement, drainage of abscess and then was started on ATT. Both had excellent outcomes at the end of one year follow up. We reviewed previous published literature of isolated scapular tuberculosis. The most common presentation of scapular tuberculosis is as follows: age less than 30 years and there is no difference with respect to gender. Swelling and pain are the commonest symptoms. Lytic areas with surrounding sclerosis is the commonest radiological finding. Body of the scapula is affected most commonly. Prognosis is excellent with adequate treatment.


CONCLUSIONS
To conclude, clinicians should have high index of suspicion for diagnosing this condition as it mimics tumors. Pain and swelling is the most common presentation of scapular tuberculosis. Radiography shows lytic lesion with marginal sclerosis. The prognosis is excellent with appropriate treatment.
Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry. India.
Gopisankar
G
Balaji
Department of Orthopaedics Unit 1, Christian Medical college, Vellore. India.
Justin
J
Arockiaraj
Department of Orthopaedics Unit 1, Christian Medical college, Vellore. India.
Alfred Cyril
AC
Roy
Department of Orthopaedics Unit 1, Christian Medical college, Vellore. India.
Anand
A
Ashok
Tuberculosis; osteomyelitis; scapula