American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is characterized by pain, stiffness, and swelling that occur gradually, often after trauma or overuse, with a predominance in women over 70?

1. Giant Cell Arteritis

2. Milwaukee Shoulder Syndrome

3. Mixed Connective Tissue Disease

4. Rheumatoid Arthritis

The correct answer is: Milwaukee Shoulder Syndrome

The condition characterized by pain, stiffness, and swelling that develops gradually, often following trauma or overuse and occurs predominantly in women over the age of 70, is Milwaukee Shoulder Syndrome. This condition is specifically associated with degenerative changes in the shoulder joint, which can lead to significant pain and disability. It often manifests in older adults who may have had previous shoulder injuries or who have engaged in repetitive activities that stress the joint. Milwaukee Shoulder Syndrome is notable for its insidious onset and can present with symptoms similar to other shoulder disorders, but its unique demographic (predominantly women over 70) and the association with prior trauma or overuse help in distinguishing it from other conditions listed. It typically involves a specific kind of severe destructive change in the glenohumeral joint and often requires imaging studies for diagnosis as well as management strategies that may include physical therapy and, in some cases, surgical interventions. The other conditions, while they may share similar features such as pain and stiffness, do not align with the specific demographic and clinical presentation described in the question.