Shoulder Lesion in a 69 Year Old Woman
| Autor: | Andrew J. Hayden, Chuanyong Lu, Aditya V. Maheshwari, Michael A. Stracher, Adele L. Boskey, Steven A. Burekhovich, Srinivas Kolla |
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| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
030506 rehabilitation medicine.medical_specialty Neoplasms Radiation-Induced Biomedical Engineering Bone Neoplasms Breast Neoplasms Malignancy Infections Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Shoulder Pain Arthropathy medicine Humans Medical history Rotator cuff General Dentistry Aged Neck pain business.industry Amyotrophic Lateral Sclerosis Sarcoma medicine.disease Surgery medicine.anatomical_structure Female Rotator Cuff Tear Arthropathy Milwaukee shoulder syndrome Differential diagnosis medicine.symptom 0305 other medical science business Range of motion 030217 neurology & neurosurgery |
| Zdroj: | Journal of long-term effects of medical implants. 28(1) |
| ISSN: | 1940-4379 |
| Popis: | Milwaukee Shoulder Syndrome (MSS) is a painful progressive arthropathy in which hydroxyapatite crystal deposition in synovial tissue induces lysosomal release of collagenase and neutral proteases. These enzymes are destructive to periarticular tissue, including the synovium, articular cartilage, rotator cuff muscles, and the intrasynovial cortical bone. MSS predominantly occurring in women (90%) over the age of 70 years of age with a clinical history marked by recurrent joint effusions and pain, which classically worsens at night. Our patient is a 69-year-old woman who presented with progressive shoulder pain, most prominent at night, with limited range of motion and swelling; intermittent discharge; and intermittent neck pain that radiated to her right upper extremity. Her medical history was notable for invasive carcinoma of the right breast treated with mastectomy and radiation. She was also treated with radiation therapy for right shoulder pain and a lucent right shoulder lesion presumed to be metastatic breast cancer. The remainder of her medical history consists of hypertension, diabetes mellitus, hyperlipidemia, and uneventful bilateral total knee arthroplasties. At presentation, she denied constitutional symptoms. Based on the patient's history and physical exam the differential diagnosis included primary and metastatic malignancy, radiation induced sarcoma and necrosis, infection, Charcot disease, and crystal arthropathies. Physical exam, laboratory findings, and imaging studies led us to the diagnosis of MSS. |
| Databáze: | OpenAIRE |
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