Milwaukee shoulder syndrome associated with pigmented villonodular synovitis. Case report

Milwaukee shoulder syndrome (MSS) describes a destructive shoulder arthropathy associated with of calcium hydroxyapatite and calcium pyrophosphate dihydrate crystals deposition found mainly in elderly women. Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder of the synovium usually seen in young adults, found frequently in the knee joint. We present the case of a 63 year old Caucasian woman admitted for severe swelling of the left shoulder and mild pain, with 10 years history. Clinical signs, laboratory tests, imaging studies, and histopathological examinations established the diagnosis of MSS associated with PVNS. Surgical partial synoviectomy followed by radiotherapy (total dose 36 Gy) was considered with local improvement. This is the first report in literature about this association.