A 42 year old febrile non intravenous drug user male presented with a painful right shoulder and a history of trauma 4 weeks earlier without evidence of overlying skin penetration. Inflammatory markers were elevated and a blood culture was positive for Staphylococcus aureus. Initial interpretations of plain radiographs and computed tomography (CT) of the right shoulder were non-diagnostic. A bone scan confirmed septic arthritis and osteomyelitis of the acromioclavicular joint (ACJ) and allowed prompt recognition and effective therapy to prevent joint destruction without the need for tissue culture. Case Report A 42 year old febrile non intravenous drug user male presented with a painful right shoulder and a history of trauma 4 weeks earlier without evidence of overlying skin penetration. Inflammatory markers were elevated and a blood culture was positive for Staphylococcus aureus. Initial interpretations of plain radiographs and computed tomography (CT) of the right shoulder were non-diagnostic. A bone scan confirmed septic arthritis and osteomyelitis of the acromioclavicular joint (ACJ) and allowed prompt recognition and effective therapy to prevent joint destruction without the need for tissue culture.
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