Case Challenge

Shoulder

Stephen J Pomeranz

Gain confidence interpreting Shoulder MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME!

Case Review

Musculoskeletal (MSK)

Case 1 - 59-year-old female presents with left shoulder pain

Case 2 - 40­-year­-old male presents with left shoulder injury

Case 3 - 53-year-old male patient presents with pain and catching of the right shoulder

Case 4 - 40-year-old female presents with right shoulder pain

Case 5 - 39-year-old male presents with left shoulder pain

Case 6 - 73-year-old male presents with severe left shoulder pain

Case 7 - 53-year-old male presents with popping and pain on top of left shoulder

Case 8 - 49-year-old reports with left shoulder pain

Case 9 - 61-year-old female presents with right shoulder pain

Case 10 - 15-year-old male has alleged recurrent dislocation in his right shoulder

Case 11 - 10-year-old female presents with right scapular mass and pain

Case 12 - 58-year-old male presents with bilateral shoulder pain

Case 13 - 15-year-old female cheerleader presents with right shoulder pain

Case 14 - 17-year-old female presents with right shoulder pain

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 14 unique Shoulder MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Shoulder MRI Cases

<div>History:&#160;This 53-year-old male presents with popping and pain on top of the left shoulder with decreased range of motion.MOST LIKELY DIAGNOSIS:&#160;Primary synovial chondromatosisUsing the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.<figure class="wp-block-image"><img src="https://process.fs.teachablecdn.com/ADNupMnWyR7kCWRvm76Laz/resize=width:750/https://www.filepicker.io/api/file/jGCaTlnlTkSppQVeLida" alt=""></figure>CLINICAL CONSIDERATIONS:Q1 &#8211;&#160;What is your differential diagnosis?Q2 &#8211;&#160;What is the important difference between the primary and secondary forms of this disorder?A1 &#8211;&#160;Differential diagnosis includes secondary synovial chondromatosis as a manifestation of osteoarthritis; donated chondral bodies from osteochondral defects; osseous bodies; and synovial hyperplasia.Secondary synovial chondromatosis is usually associated with osteoarthritis and you would have been shown an arthritic joint. Chondral bodies are usually not this organized in their shape and size, namely elliptical and smooth. Further, you would have been shown the osteochondral donor site. Osseous bodies would be marrow containing or brighter on T1 and more hypointense on T2. Synovial hyperplasia is not quite so organized and elliptical in shape. The fronds of synovial hyperplasia are smaller. Furthermore, this is a 53-year-old male and synovial hyperplasias are associated with rheumatoid arthritis and seen in women. You would have also been shown other signs of rheumatoid arthritis.Other unusual intraarticular hypointensities include&#160;amyloid&#160;(rare) which is not quite so organized in shape;&#160;gouty tophi&#160;also not so organized in shape; and&#160;localized PVNS&#160;(more hypointense on T2 and more hyperintense on T1).A2 &#8211;&#160;It is important to distinguish primary from secondary synovial chondromatosis as the primary form can be associated with malignant degeneration while the secondary form has no association with increased incidence of malignancy.</div>

Case