Milwaukee Shoulder

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Milwaukee Shoulder

Milwaukee shoulder refers to a destructive shoulder arthropathy due to deposition of hydroxyapatite crystals, and identification of these crystals in synovial fluid is the cornerstone of diagnosis.

Milwaukee shoulder frequently affects older women, often with a history of trauma to the region.

Clinical presentation :

Symptoms are usually comparatively mild, despite rapid and marked progression of radiographic features.

Radiographic features :

Plain radiograph :

- Radiographic findings are striking and almost resembles a neuropathic joint :

Destruction with intra-articular loose bodies,

subchondral sclerosis, soft tissue swelling and rotator cuff disruption.

Cases often demonstrate superior subluxation of the humeral head in relation to the glenoid fossa The superior subluxation can also result in a pseudoarthrosis with the distal clavicle and/or acromion

MRI findings :

large shoulder joint effusion

complete rotator cuff tear

narrowing of the glenohumeral joint

thinning of cartilage

destruction of subchondral bone

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