Presentation
Chronic shoulder pain.
Patient Data
Extensive bony destruction and remodeling, intra-articular loose bodies, large effusion and soft tissue swelling.
Ultrasound demonstrated a complete supraspinatus tear as well as a large amount of joint fluid. This was aspirated and sent for cytology.
Intra-articular betamethasone and bupivacaine were then injected under aseptic technique.
Case Discussion
This is a classic appearance of Milwaukee shoulder. The patient had a longstanding history of chronic pain and deformity. She presented for symptomatic treatment with ultrasound guided aspiration and intra-articular steroid injection.
On ultrasound there was a complete supraspinatus tear and a large effusion, aspiration yielded pale blood stained fluid which demonstrated hydroxyapatite crystals on cytology.