Age / Sex : 77 / F

Age / Sex : 77/F

Chief complaint : Rt. Shoulder pain (onset: 7Mon)

Amyloidosis

Discussion

Findings:

T2 dark SI diffuse synovial thickening of Rt. glenohumeral joint

T2 dark SI severe subdeltoid bursal thickening

Large bone erosion of humerus head-neck junction

Heterogeneous T1 low bone marrow SI change of covered T-L spine

Differential Diagnosis:

Pigmented Villonodular Synovitis (PVNS)

Tuberculous arthritis

Diagnosis:  

US guided needle biopsy of subdeltoid bursal mass was done.

Amyloidosis related to multiple myeloma

Discussion:

•       Not single disease but a heterogeneous group of diseases characterized by abnormal extracellular deposition of insoluble proteins in bone and soft tissue

•       most commonly seen in patients undergoing chronic hemodialysis (and is caused by elevated serum levels of 2-microglobulin) and in patients with plasma cell dyscrasia (in these patients, amyloid arthropathy is caused by elevated serum levels of monoclonal immunoglobulin light chain fragments)

•       Involve shoulder, acetabular, hip and carpal bones

•       10~15% of patients with multiple myeloma

 References:

J HK Coll Radiol. 2009;12:12-15