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. The knees are affected in ~50% of cases.
Milwaukee shoulder frequently affects older women, often with a history of trauma to the region.
Symptoms are usually comparatively mild, despite rapid and marked progression of radiographic features.
The plain film findings are striking and almost resembles a neuropathic joint, with advanced articular surface destruction with intra-articular loose bodies, subchondral sclerosis, soft tissue swelling and rotator cuff disruption.
MRI findings mirror those of the plain films and include:
- large shoulder joint effusion
- complete rotator cuff tear
- narrowing of the glenohumeral joint
- thinning of cartilage
- destruction of subchondral bone
Treatment and prognosis
No specific treatment is available (i.e. supportive treatment for symptom relief) 3.
General imaging differential considerations include
- Charcot joint
- rapidly destructive osteoarthritis of the hip
- vanishing bone disease
- advanced secondary osteoarthritis
- previous trauma
- previous septic arthritis
- 1. Dondelinger RF, Marcelis S, Daenen B et-al. Peripheral Musculoskeletal Ultrasound Atlas. Thieme. (1996) ISBN:0865775923. Read it at Google Books - Find it at Amazon
- 2. Llauger J, Palmer J, Rosón N et-al. Nonseptic monoarthritis: imaging features with clinical and histopathologic correlation. Radiographics. 2000;20 Spec No : S263-78. Radiographics (full text) - Pubmed citation
- 3. Santiago T, Coutinho M, Malcata A et-al. Milwaukee shoulder (and knee) syndrome. BMJ Case Rep. 2014;2014 (may14 4): . doi:10.1136/bcr-2013-202183 - Pubmed citation
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Milwaukee shoulder (and knee) syndrome||✗|
|Milwaukee shoulder syndrome (MSS)||✗|