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

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.