Milwaukee Shoulder (MS)! Companion case to calcific tendinopathy. When hydroxyapatite gets deposited within the glenohumeral articulation, a rapidly destructive arthropathy ensues. The intra-articular hydroxyapatite acts as a foreign body and it gets phagocytized by the surrounding synovial cells. The cells then release cytokines and protease that end up reabsorbing and “destroying” the surrounding bone. MS usually happens in older females and in 64% of the cases presents bilaterally. On imaging we see articular destruction associated to a "calcific density" effusion, as we can see in this case. The differential diagnosis includes other destructive arthropathies such as Charcot (related to syringomyelia), septic arthritis, hemophilia and amyloid arthropathy. Glenohumeral joint destruction + intra articular calcification = Milwaukee Shoulder! Happy New Year from the MSK Radiology Genie! #mskrad #mskradiology #msk🧞♂️ #radiologyeducation
