Delayed Diagnosis of Shoulder Septic Arthritis and Osteomyelitis During the COVID-19 Pandemic: The Role of Point-of-Care Ultrasound

Lachlan Driver; Kathleen McFadden; Nour Al Jalbout; Hamid Shokoohi

doi:10.7759/cureus.35460

Delayed Diagnosis of Shoulder Septic Arthritis and Osteomyelitis During the COVID-19 Pandemic: The Role of Point-of-Care Ultrasound

Cureus. 2023 Feb 25;15(2):e35460. doi: 10.7759/cureus.35460. eCollection 2023 Feb.

Authors

Lachlan Driver¹, Kathleen McFadden², Nour Al Jalbout¹, Hamid Shokoohi¹

Affiliations

¹ Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
² Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.

Abstract

The diagnosis and treatment of septic arthritis are complex and require collaboration among multiple medical services, especially in the emergency department (ED). This case report highlights the difficulties in diagnosing shoulder septic arthritis, which is a rare condition in adults and can present with subtle symptoms. The patient was eventually diagnosed with septic arthritis of the left shoulder. However, the diagnosis was delayed due to the impact of the COVID-19 pandemic on obtaining an outpatient MRI and a previous shoulder injury that added confusion. Delays in diagnosis and treatment can lead to a rapid destruction of the affected joint, causing significant morbidity and mortality. This case report also highlights the importance of alternative diagnostic tools, such as point-of-care ultrasound (POCUS), which is quick, inexpensive, and may lead to earlier detection of joint effusions and prompt arthrocentesis.

Keywords: covid-19; osteomyelitis; point-of-care ultrasound; septic arthritis; septic shoulder.

Publication types

Case Reports