[Milwaukee shoulder syndrome (apatite associated destructive arthritis): therapeutic aspects].
Milwaukee shoulder is a well defined clinical entity that can be observed in particular in older women. It is a destructive arthropathy associated with the deposition of calcium pyrophosphate dihydrate crystals, characterized by the presence of large amount of synovial fluid and a complete tear of the rotator cuff. Clinical features include pain, swelling and progressive functional impairment. The first-line treatment include the use of analgesic drugs and repeated arthrocentesis followed by intra-articular steroid administration; closed-needle tidal irrigation has been reported to be useful. In late phase we can observe narrowing of the acromion-humeral and of the gleno-humeral joint and progressive degenerative changes at the humeral head, leading to almost complete functional impairment. In these cases a surgical approach with total shoulder arthroplasty may be considered.
Unità Operativa di Reumatologia, IRCCS Policlinico San Matteo, Piazzale Camillo Golgi 19, Pavia, Italy. o.epis@smatteo.pv.it
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Epis
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Viola
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Bruschi
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Benazzo
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Montecucco