American Board of Internal Medicine (ABIM) Certification Practice Exam

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What condition is characterized by basic calcium phosphate deposition and typically affects women over 70?

  1. Rheumatoid arthritis

  2. Osteoarthritis

  3. Gout

  4. Milwaukee shoulder syndrome

The correct answer is: Milwaukee shoulder syndrome

Milwaukee shoulder syndrome is characterized by the deposition of basic calcium phosphate (BCP) crystals, which can lead to a range of symptoms, including pain and limited movement in the shoulder. This condition predominantly affects older women, especially those over the age of 70, which aligns with the demographic presented in the question. The pathophysiology involves the accumulation of BCP crystals in the joint, resulting in inflammation and potentially leading to joint destruction. It’s important to note how this differs from other conditions: osteoarthritis, for example, involves the degeneration of cartilage and affects both genders relatively equally, and gout is associated with uric acid crystals rather than calcium phosphate. While rheumatoid arthritis can also occur in older adults, it is primarily an autoimmune condition affecting all genders and is not linked to BCP deposits.

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