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Case of the Week 614


What is the most likely diagnosis?

  • 63 year-old with swollen and mildly painful right shoulder



Frontal and Axillary View of Right Shoulder

  1. Osteoarthritis
  2. Gout
  3. Old Trauma
  4. Ewing Sarcoma
  5. Charcot Arthropathy

Additional Image - None

 

Additional Images

 

 

None


Answer:

5. Charcot Arthropathy

More (Click Discussion Tab)

 

 

Charcot Arthropathy

General Considerations

  • Most commonly caused by diabetes today
  • Bilaterally is rare in foot
  • Disturbance in sensation leads to multiple microfractures
    • Pain sensation is intact from muscles and soft tissue
  • Distribution and causes
    • Shoulders – syringomyelia, spinal tumor
    • Elbows and wrists -- syringomyelia
    • Hips – tertiary syphilis, diabetes
    • Knees – tertiary syphilis (more bone production), diabetes (less bone production)
    • Feet – diabetes, congenital insensitivity to pain, chronic alcoholism

MORE . . .


.

This Week

63 year-old with swollen and mildly painful right shoulder
 
 



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LearningRadiology.com
is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.