Abstract | March 15, 2024

The Management of a Subscapular Abscess in a Pediatric Patient

Sarthak Parikh, D.O. Saint Francis Health Systems, Tulsa OK; Oklahoma State University Department of Orthopedic Surgery, Tulsa OK

Jonathon Gurule, D.O., Oklahoma State University Department of Orthopedic Surgery, Tulsa OK; Jay Thompson, D.O., Oklahoma State University Department of Orthopedic Surgery, Tulsa OK; Mark Schwartz, D.O., Oklahoma State University Department of Orthopedic Surgery, Tulsa OK, Steven A. Brown, D.O., Oklahoma State University Department of Orthopedic Surgery, Tulsa OK

Learning Objectives

  1. Management of arthroscopic debridement is a viable choice for the management of pediatric subscapular abscesses
  2. This case contributes to the uncommon literature discussing the incidence of pediatric subscapular abscesses

A subscapular abscess is a rare condition in both adult and pediatric patients that is scarcely represented in the literature. Current research demonstrates only 5 other case reports of pediatric subscapular abscess, making it an unlikely differential diagnosis for pediatric physicians treating infective causes of shoulder pain. The purpose of this study is to present the history, diagnosis and management of a 2-year-old female with a left subscapular abscess that was treating with arthroscopic irrigation and debridement and offer management suggestions based on inferences of the current literature discussing pediatric subscapular abscesses. Most cases were caused by both MRSA and MSSA. Patients infected with MRSA developed re- accumulation of fluid that necessitated multiple procedures. Falls were associated in 3 of the 6 cases. Although one patient was managed with ultrasound guided aspiration and antibiotics, the author recommends operative intervention for abscess evacuation as drainage may not sufficiently eradicate the infection, especially if the pathogen is MRSA. Furthermore, practitioners should consider subscapular abscesses as a differential diagnosis when pediatric patients present similarly to septic glenohumeral arthritis without specific clinical findings. These suggestions and findings are limited primarily due to the paucity of research discussing subscapular abscesses in pediatric patients and should be interpreted cautiously. Further publications of subscapular abscesses in both the adult and pediatric patients are encouraged.

References and Resources

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  2. San Joaquin VH, Kimball JB. Subscapular abscess due to Haemophilus influenzae type B. Pediatrics. 1980;65(2):331-332.
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