Rare syndrome erased man's shoulder joint, doctors report
A rare condition destroyed a construction worker's shoulder joint, leaving the upper arm bone free-floating. Doctors diagnosed Milwaukee Shoulder Syndrome.
A 45-year-old construction worker went to an emergency department because his right shoulder was severely swollen and getting more painful. An X-ray revealed an unusual cause: the entire shoulder joint was missing, seemingly shattered into small remaining pieces.
Normally, the shoulder is a ball-and-socket joint, with the round head of the humerus sitting in a socket in the shoulder blade. According to a case report in the New England Journal of Medicine, the man's X-ray showed no ball and no intact socket. The humerus was detached from the joint, and its spherical head was completely gone. The broken, headless bone floated freely in the arm, unattached to the rest of the body.
Magnetic resonance imaging showed that the rotator cuff — the group of muscles and tendons that holds the upper arm bone in the socket — was also destroyed. Three of the four main tendons (supraspinatus, infraspinatus, and subscapularis) had full-thickness tears.
The man was diagnosed with Milwaukee Shoulder Syndrome (MSS), a rare, destructive condition. The name was coined in 1981 after four elderly women in Wisconsin had severe shoulder joint destruction and massive rotator cuff tears. The syndrome is similar to — and possibly a subtype of — rapid destructive arthritis, which was identified a year later in 1982.
