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Milwaukee shoulder syndrome — SCE Rheumatology MCQ

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HardCrystal ArthropathiesMilwaukee shoulder syndromeSCE Rheumatology

An older patient has a rapidly destructive shoulder, massive cuff tear, large non-inflammatory effusion and basic calcium-phosphate debris. What management is most appropriate?

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Correct answer: A — Use symptom control, aspiration and cuff-directed rehabilitation

The best answer is “Use symptom control, aspiration and cuff-directed rehabilitation”. Milwaukee-shoulder syndrome is a destructive basic calcium-phosphate arthropathy associated with cuff failure; management is supportive and tailored, with aspiration, analgesia, physiotherapy and selected surgical input. Antibiotics, allopurinol, routine synovectomy and vasculitis treatment do not address the mechanism.

Reference: NHS musculoskeletal shoulder assessment guidance: https://www.nhs.uk/conditions/shoulder-pain/