Shoulder Lesion in a 69 Year Old Woman.

Area of Science:

• Rheumatology
• Orthopedics
• Crystal Arthropathies

Background:

• Milwaukee Shoulder Syndrome (MSS) is a rare, progressive arthropathy.
• Characterized by hydroxyapatite crystal deposition in synovial tissue.
• Leads to enzymatic destruction of shoulder joint structures.

Observation:

• A 69-year-old woman presented with progressive shoulder pain, swelling, and limited range of motion.
• Her history included breast cancer treated with radiation therapy, complicating the differential diagnosis.
• Initial symptoms mimicked malignancy, infection, or radiation-induced necrosis.

Findings:

• Physical examination, laboratory results, and imaging studies confirmed MSS.
• The patient's presentation included night pain, joint effusions, and intermittent discharge.
• Differential diagnoses considered were malignancy, radiation effects, infection, and crystal arthropathies.

Implications:

• This case underscores the importance of considering MSS in patients with shoulder pain, especially those with a history of radiation.
• Accurate diagnosis of MSS is crucial for appropriate management and to avoid misdiagnosis of more severe conditions.
• Further research into MSS pathogenesis and treatment is warranted.