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      Enhanced MR imaging of the shoulder, and sternoclavicular and acromioclavicular joint arthritis in primary hemochromatosis

      case-report

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          Abstract

          Shoulder arthritis is a common feature of hemochromatosis. However, a combination of sternoclavicle (SC) and acromioclavicular (AC) joint involvement associated with shoulder is uncommonly seen. We describe the MR imaging findings of the shoulder and SC and AC joint in a patient with primary hemochromatosis. MRI of the left shoulder revealed inflammatory arthritis and 1-cm erosion of the humeral head, enlargement of the anterior glenoid labrum and formation of glenoid labral ovoid mass due to iron deposit. MRI of the AC joint showed inflammation and erosion with joint fluid. Significant contrast enhancement was noted at the SC joint due to inflammation.

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          Most cited references9

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          The arthritis of hemochromatosis. A review of 25 cases with special reference to chondrocalcinosis, and a comparison with patients with primary hyperparathyroidism and controls.

          Twenty-five cases of hemochromatosis established on histological grounds were reviewed in order to study their articular complaints. Symptoms relating to articular damage were the first signs of the disease in about one quarter of the cases. More than half of the patients (n = 14) exhibited inflammatory arthritis, usually of the hands and knees. The arthritis was chronic in all the patients. Acute arthritis of the joints of the hands and feet appeared in the course of the disease in two patients. Chondrocalcinosis was present in 20% of cases with X-rays of joints (n = 20). The classical subchondral arthropathy was observed in the metacarpophalangeal joints in 35% of the patients. In two patients chondrocalcinosis and subchondral arthropathy were both present. These data are compared with those of 66 patients suffering from primary hyperparathyroidism and of 229 controls with rheumatic complaints. The severity of the arthropathy in hemochromatosis is stressed.
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            Essentials of shoulder MR arthrography: a practical guide for the general radiologist.

            Lesions of the glenoid labrum and ligamentous structures commonly occur secondary to shoulder trauma and are a frequent cause of shoulder joint instability. Numerous eponyms, acronyms and subclassifications are used to describe the often confusing array of bony and labro-ligamentous abnormalities of the shoulder. This aim of this review is to illustrate the relevant features of these lesions and to provide a systematic and practical approach to imaging of the shoulder using MR arthrography.
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              Radiological features of the visceral and skeletal involvement of hemochromatosis.

              Hemochromatosis is a multisystem disorder produced by the excessive accumulation of iron in visceral organs and the musculoskeletal system. Clinically the disease may be silent, but characteristic radiological features may point to the diagnosis. The increased iron stores in the organs involved, especially in the liver and pancreas, result in an increased attenuation at unenhanced CT and an decreased signal intensity at MR imaging. Hemochromatosis arthropathy includes degenerative osteoarthritis and chondrocalcinosis. The distribution of the arthropathy is distinctive, but not unique, frequently affecting the second and third metacarpophalangeal joints of the hand.
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                Author and article information

                Contributors
                drffarpour@yahoo.com
                Journal
                Rheumatol Int
                Rheumatology International
                Springer-Verlag (Berlin/Heidelberg )
                0172-8172
                1437-160X
                14 October 2009
                14 October 2009
                March 2011
                : 31
                : 3
                : 395-398
                Affiliations
                University of California, Irvine (UCI)/VA, Irvine, USA
                Article
                1193
                10.1007/s00296-009-1193-z
                3041921
                19826815
                32f5b864-6c87-40ca-add7-cfa7ca1521e8
                © The Author(s) 2009
                History
                : 11 August 2009
                : 20 September 2009
                Categories
                Case Report
                Custom metadata
                © Springer-Verlag 2011

                Rheumatology
                hemochromatosis,shoulder,mr imaging,sc joint,arthropathy,ac joint
                Rheumatology
                hemochromatosis, shoulder, mr imaging, sc joint, arthropathy, ac joint

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