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Emergency Medicine Journal 2007;24:e8; doi:10.1136/emj.2006.041723
© 2007 BMJ Publishing Group Ltd and the College of Emergency Medicine.

EMERGENCY CASEBOOK

Necrotising myositis: a surgical emergency that may have minimal changes in the skin

G H Smith, J S Huntley, G F Keenan

Department of Orthopaedics, Royal Infirmary Edinburgh, UK

Correspondence to:
Correspondence to:
G Smith
Department of Orthopaedics, Royal Infirmary Edinburgh, UK; georgesmith{at}doctors.org.uk

ABSTRACT

Necrotising myositis is a surgical emergency. It is underappreciated that it may present without changes in the skin. Diagnosis is therefore often delayed. We describe a case of necrotising myositis necessitating glenohumeral disarticulation. Remarkable features were the absence of skin signs and the rapidity with which the patient became extremely septic. A review of the literature has shown the importance of early diagnosis and quick decision making to minimise mortality.


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