J Korean Diabetes.  2015 Sep;16(3):218-224. 10.4093/jkd.2015.16.3.218.

Humeral Osteomyelitis due to Staphylococcal aureus Infection as the Initial Presentation of Diabetes Mellitus

• Baek CO
• Kim KH
• Song SK
• Lee JM
• Kim JH

• KMID: 2149293
• DOI: http://doi.org/10.4093/jkd.2015.16.3.218

Abstract

Diabetes mellitus is a common disorder and presents in different ways. Shoulder pain is a common musculoskeletal complaint, especially in middle-aged or older-aged men. While it is widely accepted that diabetics have an increased propensity to develop infections, a diagnosis of osteomyelitis of the humerus as the etiology of constant shoulder pain might be delayed, as occurred in this case study, until patients' develop clear signs of infection. Here, we describe a case of subacute osteomyelitis as the first physical symptom of diabetes; the possibility of osteomyelitis should therefore be investigated in all patients with diabetes mellitus who develop joint or bone-related pain.

Keyword

Diabetes mellitus; Humerus; Osteomyelitis

MeSH Terms

Diabetes Mellitus*
Diagnosis
Humans
Humerus
Joints
Male
Osteomyelitis*
Shoulder Pain

Figure

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  Fig. 1. (A) Simple x-ray of the shoulder showed near normal findings except for a small bone spur at the glenoid of the scapula and an incidental mid-humeral osteolytic lesion that was missed upon first examination (arrow). (B) The bone scan showed significantly increased uptake in the mid-shaft of the left humerus. (C) Fat-saturated contrast-enhanced T1 weighted magnetic resonance imaging (sagittal view) revealed Brodie's abscess formation in the proximal 1/3 and mid-shaft of the left humerus accompanied by diffuse bone marrow signal change and adjacent soft tissue swelling with juxtacortical abscess formation.

Reference

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