Four cases of "Milwaukee shoulder," with a description of clinical presentation and long-term treatment

Nonpharmacologic and pharmacologic management of CPP crystal arthritis and BCP arthropathy and periarticular syndromes

Calcium crystal arthritis is often unrecognized, poorly managed, and few effective therapies are available. The most common types of calcium crystals causing musculoskeletal syndromes are calcium pyrophosphate (CPP) and basic calcium phosphate (BCP). Associated syndromes have different clinical presentations and divergent management strategies. Acute CPP arthritis is treated similarly to acute gouty arthritis, whereas chronic CPP and BCP arthropathy may respond to strategies used for osteoarthritis. Calcific tendonitis is treated with a variety of interventions designed to dissolve BCP crystals. A better understanding of the causes and larger well-planned trials of current therapies will lead to improved care.

Radiographic evaluation of osteoarthritis

Osteoarthritis is the most widespread form of arthritis in the United States. Classically, osteoarthritis has been grouped into primary and secondary types. Primary or idiopathic osteoarthritis is believed to be a sequela of altered biomechanical stresses across joints in susceptible individuals. Secondary osteoarthritis is a consequence of underlying cartilage damage, such as from preceding inflammatory arthritis, metabolic abnormality, or injury. The radiographic hallmark of osteoarthritis is asymmetric loss of cartilage space. Osteophytosis bony eburnation, subchondral cysts, and eventual subluxation follow. Osteoporosis and erosions are not usual features of this disease.