Chronic osteomyelitis at the base of coracoid process: an unusual location

Chronic osteomyelitis of the coracoid process is extremely rare with limited medical literature. This case reported a 17-year-old male who presented with persistent left shoulder pain and restricted range of motion for 2 months without a history of trauma. Imaging revealed an osteolytic lesion at the base of the coracoid process, confirmed by surgical biopsy. Initially, the patient underwent conservative management with non-steroidal anti-inflammatory drugs, but symptoms persisted, requiring surgical intervention involving decortication, biopsy, and fixation of the lesion using a screw. Histopathological analysis confirmed chronic osteomyelitis, and postoperative intravenous antibiotics for 3 weeks then symptom relief and restored shoulder function. This case highlights the diagnostic challenges for atypical presentation of chronic osteomyelitis in rare anatomical sites, emphasizing the importance of advanced imaging, prompt surgical intervention, and biopsy confirmation. Clinicians should consider osteomyelitis in the differential diagnosis of persistent shoulder pain, even in the absence of trauma or systemic signs of infection.