American Board of Internal Medicine (ABIM) Certification Practice Exam

What symptoms characterize Milwaukee shoulder syndrome?

1. Fever and fatigue

2. Pain, stiffness, and swelling

3. Signs of infection

4. Joint hypermobility

The correct answer is: Pain, stiffness, and swelling

Milwaukee shoulder syndrome is primarily characterized by pain, stiffness, and swelling in the shoulder joint. This condition often presents with rapid onset of severe shoulder pain and limited range of motion, which can be accompanied by swelling due to the accumulation of fluid in the joint. Patients may experience significant discomfort, leading to impaired daily activities. The distinguishing feature of Milwaukee shoulder syndrome is that these symptoms arise from the effects of hydroxyapatite crystal deposition or other degenerative changes in individuals, often with underlying factors such as age, previous trauma, or chronic conditions. These typical symptoms align with the definition of this syndrome and help in differentiating it from other shoulder pathologies. In contrast, fever and fatigue are more common in systemic infections or inflammatory conditions, signs of infection would suggest an infectious process rather than a syndrome typically characterized by crystal deposition, and joint hypermobility is not associated with Milwaukee shoulder syndrome but rather with connective tissue disorders. Understanding these aspects allows for proper recognition and management of the syndrome.