title: Persistent hemarthrosis of the shoulder joint with a rotator-cuff tear in the elderly.
abstract: Three elderly patients developed persistent hemarthrosis of the shoulder joint without having suffered injury. Complete tears of the rotator cuff, attrition of the undersurface of the acromion, and instability were noted in the affected shoulders. Synovial fluids examined from two patients contained many alizarin red S-positive microspheroids. The synovium obtained at surgery from two patients showed hypervascularity, vasodilatation, and severe degenerative changes of collagenous tissues. The tendon of the m. supraspinatus showed infiltrations of multinucleated giant cells around calcified deposits consisting of hydroxyapatite crystals. Anatomical and mechanical derangements, and possible biological reactions following phagocytosis of hydroxyapatite crystals, may have contributed to the persistent hemorrhage in the shoulder joints.
authors.affiliation: Department of Orthopedic Surgery, Kumamoto University Medical School, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ishikawa
authors.forename: T
authors.initials: T
authors.lastname: Ohira
authors.forename: K
authors.initials: K
authors.lastname: Morisawa
mesh_terms: D000174:Acromion / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006395:Hemarthrosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D011859:Radiography; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery; D000074402:Synovectomy; D013583:Synovial Membrane / Q000473:pathology; D013708:Tendon Injuries; D013710:Tendons / Q000473:pathology / Q000601:surgery