PMC9958378_01
Swollen right shoulder after joint aspiration.
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An 89-years-old man, known for rheumatoid arthritis treated sporadically with methylprednisolone (none in the last 3 months), presented at the emergency department for an acute painful and swollen right shoulder without any traumatism [Fig. 1].
X-ray of the right shoulder, showing severe omarthrosis with large peri humeral effusion.
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A conventional x-ray revealed severe excentric omarthrosis and a large peri humeral effusion with several calcifications on its periphery [Fig. 2].
Ultrasonography of the right shoulder, revealing acromioclavicular synovitis.
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Extension of the bursa was noted to the mid-humerus [Fig. 3].
Thick hemorrhagic joint liquid with some macrocalcifications.
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A joint aspiration revealed a thick hemorrhagic liquid with some macrocalcifications [Fig. 4].
Microscopic image of a Gram-stained smear of Capnocytophaga carnimorsus from blood culture, demonstrating small and thin Gram-negative rods. Magnification, x1000.
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The Gram-negative rod was identified as C. canimorsus with a reliable score of 2.1 [Fig. 5].