{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T19:38:05Z","timestamp":1788377885266,"version":"build-2803163510"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,2,28]]},"abstract":"<jats:p>We present a rare case of a subscapularis pyomyositis in a 38-year-old woman and examine the diagnostic and surgical challenges posed. History and examination features were similar to that of septic shoulder arthritis without overlying features of warmth or erythema. Serological markers revealed a C-reactive protein of 221\u2009mg\/L and white cell count of 11.1\u00d710<jats:sup>9<\/jats:sup>\/L. A dry shoulder aspirate was obtained. Contrast-enhanced MRI demonstrated a peripheral rim-enhancing lesion within the subscapularis muscle belly with lack of central enhancement. These features are consistently seen with an infective aetiology. A deltopectoral approach to surgical drainage was utilised and subsequent fluid cultures grew Panton\u2013Valentine Leukocidin positive <jats:italic>Staphylococcus aureus<\/jats:italic> species. This rare bacterium is associated with an increased risk of osteomyelitis and despite making a full recovery, the patient was advised to reattend if any future shoulder pain was encountered.<\/jats:p>","DOI":"10.1136\/bcr-2017-223982","type":"journal-article","created":{"date-parts":[[2018,3,16]],"date-time":"2018-03-16T07:31:05Z","timestamp":1521185465000},"page":"bcr-2017-223982","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Subscapularis pyomyositis: a rare presentation of shoulder pain"],"prefix":"10.1136","volume":"2018","author":[{"given":"Simond","family":"Jagernauth","sequence":"first","affiliation":[{"name":"Orthopaedic Department, Royal London Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reece Alexander James","family":"Clough","sequence":"additional","affiliation":[{"name":"Barts and The London School of Medicine and Dentistry, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Noorani","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Royal London Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muaaze","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Radiology Department, Royal London Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,3,16]]},"reference":[{"key":"2025082801373070000_2018.mar15_3.bcr-2017-223982.1","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.2106\/00004623-200212000-00024","article-title":"Primary pyomyositis","volume":"84-A","author":"Bickels","year":"2002","journal-title":"J Bone Joint Surg Am"},{"key":"2025082801373070000_2018.mar15_3.bcr-2017-223982.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2006.08.005"},{"key":"2025082801373070000_2018.mar15_3.bcr-2017-223982.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-004-0039-9"},{"key":"2025082801373070000_2018.mar15_3.bcr-2017-223982.4","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00001-08"},{"key":"2025082801373070000_2018.mar15_3.bcr-2017-223982.5","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s12098-013-1156-y","article-title":"Pyomyositis in unusual site (subscapularis and infraspinatus muscles)","volume":"81","author":"Shashikiran","year":"2014","journal-title":"Indian J Pediatr"},{"key":"2025082801373070000_2018.mar15_3.bcr-2017-223982.6","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4103\/0973-6042.131854","article-title":"Recurrent Fusobacterium pyogenic myositis of the rotator cuff. 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