Milwaukee shoulder

Dr Andrew Dixon and A.Prof Frank Gaillard et al.

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.

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. 

Radiographic 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. Cases often demonstrate superior subluxation of the humeral head in relation to the glenoid fossa 4

MRI findings mirror those of the plain radiographs and include: 

No specific treatment is available, only supportive treatment for symptom relief 3

Regius Professor of Surgery, Dr Robert Adams (1791 -1875) was an Irish surgeon who first described this pathology in his own textbook published in 1857 5.

General imaging differential considerations include

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Article information

rID: 1680
Section: Syndromes
Synonyms or Alternate Spellings:
  • Milwaukee shoulder (and knee) syndrome
  • Milwaukee shoulder syndrome (MSS)

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Cases and figures

  • Case 1: bilateral
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  • Case 2
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  • Case 3: early
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