Tag Archive for: Biopsy

Scapular Tuberculosis in the Paediatric Population: Suspicion and Early Treatment is the Key

Volume 8 | Issue 3 | September-December 2022 | Page: 11-15| Bushu Harna, Shivali Arya, Sukhmin Singh, Raj Kumar, Dhanajaya Sabat, Anil Arora

DOI- https://doi.org/10.13107/ijpo.2022.v08.i03.144

Authors: Bushu Harna [1] MS Ortho., Shivali Arya [2] MD Rad., Sukhmin Singh [3] MS Ortho., Raj Kumar [4] MS Ortho., Dhanajaya Sabat [5] MS Ortho., Anil Arora [6] MS Ortho


[1] Department of Orthopaedics, , Indus International Hospital, Panjab, India.
[2] Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.
[3] Department of Orthopaedics, AIIMS Bilaspur, Himachal Pradesh, India.
[4] Department of Orthopaedics, AIIMS, New Delhi, India.
[5] Department of Orthopaedics, Maulana Azad Medical College, New Delhi, India.
[6] Department of Orthopaedics, Max Superspecialty Hospital, Parpatganj, New Delhi, India.

Address of Correspondence

Dr. Bushu Harna,
Consultant, Department of Orthopaedics, Indus International Hospital, Panjab, India.
E-mail: bushu.edu@gmail.com


Background: Scapular tuberculosis (TB) in paediatric population is very rare and required clinician suspicion for early diagnosis and treatment.
Methods and Materials: We conducted a retrospective study involving 8 children with a diagnosis of TB of the scapula that was confirmed by histopathological examination. The patients were clinically assessed for signs and symptoms. Pediatric/adolescent shoulder survey (PASS) and numerical rating scale (NRS) scores were used to assess the improvement with treatment.
Results: The mean age of the patients was 10.5 years with a mean duration of symptoms around 4 months. All the patients had raised ESR and CRP values with MRI evidence of inflammation or cold abscess. In all the patients, either FNAC or biopsy was performed. Gene Xpert and histopathological examination confirmed the diagnosis of tuberculosis. All the patients were given (Anti-TB therapy) ATT according to their age/weight for a period of 12 months, as per the RNTCP guidelines. There was significant improvement in ESR, CRP, NRS, and PASS scores with MRI-evidence of disease resolution.
Conclusion: Scapular tuberculosis should be suspected in children presenting with vague shoulder or scapular pain. The patients should be investigated thoroughly and treated with anti-tubercular therapy.
Keywords: Flat bone tuberculosis, Scapular tuberculosis, Paediatric tuberculosis, Ant-tubercular therapy, Biopsy


1. Morris BS, Varma R, Garg A, Awasthi M, Maheshwari M. Multifocal musculoskeletal tuberculosis in children: appearances on computed tomography. Skeletal Radiol 2002;31:1-8.
2. Hosalkar HS, Agrawal N, Reddy S, Sehgal K, Fox EJ, Hill RA. Skeletal tuberculosis in children in the Western world: 18 new cases with a review of the literature. J Child Orthop 2009;3:319–24.
3. Chandane PG, Shah I, Mehta R, Jadhao N. Isolated scapular involvement: uncommon presentation of childhood tuberculosis. Oxford Medical Case Reports. 2016 Aug 1;2016(8).
4. Tripathy SK, Sen RK, Sharma A, Tamuk T. Isolated cystic tuberculosis of scapula: case report and review of literature. J Orthop Surg Res 2010;5:72.
5. Shannon FB, Moore M, Houkom JA, Waecker NJ. Multifocal cystic tuberculosis of bone. Report of a case. J Bone Joint Surg Am 1990;72:1089–92.
6. Greenhow TL, Weintrub PS. Scapular mass in an adolescent. Pediatr Infect Dis J 2004;23:84–5.
7. Husen YA, Nadeem N, Aslam F, Shah MA. Tuberculosis of the scapula. J Pak Med Assoc 2006;56:336–8.
8. Balaji G, Arockiaraj J, Cyril Roy A, Ashok A. Isolated tubercular osteomyelitis of scapula – a report of two cases and review of literature. J Orthop Case Rep 2013;3:7–11.
9. Jain D, Jain VK, Singh Y, Kumar S, Mittal D. Cystic tuberculosis of the scapula in a young boy: a case report and review of the literature. Journal of Medical Case Reports. 2009 Dec;3:1-4.
10. Teo HE, Peh WC. Skeletal tuberculosis in children. Pediatr Radiol 2004;34:853–60.

How to Cite this Article: Harna B, Arya S, Singh S, Kumar R, Sabat D, Arora A | Scapular Tuberculosis in the Paediatric Population: Suspicion and Early Treatment is the Key | International Journal of Paediatric Orthopaedics | September-December 2022; 8(3): 11-15 | https://doi.org/10.13107/ijpo.2022.v08.i03.144

(Article Text HTML)      (Full Text PDF)