Bilateral dislocation of the proximal humeral epiphyses in septic arthritis: a case report.

Intra-articular epiphyses are at risk in septic arthritis and severe epiphyseal damage is commonly seen in the hip, particularly in neonates and infants. In the first five years of life septic arthritis of the shoulder can also result in damage to the upper humeral epiphysis, but in the older child and young adult this is uncommon. Pathological displacement of the upper humeral epiphysis has not been previously reported. Case report. A 15-year-old boy presented to a district hospital with a history of fever and painful joints. The left ankle and both shoulders were warm, swollen and tender. There was no history of epilepsy and no family history of diabetes, nor had the boy suffered previous episodes ofhigh fever or trauma. The radiograph revealed displacement of both upper humeral epiphyses (Fig. 1). Both shoulders were incised and 200 ml of pus were drained from each joint.