Shoulder pad sign

Shoulder pad sign
Shoulder pad sign (A and B). Technetium-99m (99mTc)-pyrophosphate scan without any significant uptake in shoulders (C)
Differential diagnosisAL amyloidosis

The shoulder pad sign is an enlargement of the anterior shoulder due to amyloid deposition in periarticular soft tissue.[1][2][3] This type of infiltration is not common, but it is pathognomonic for AL amyloidosis.[1][2][3]

Analysis of the amyloid protein has demonstrated that it has a kappa III Ig light chain structure.[1] The variable region of kappa III amyloid proteins may show an increased likelihood of depositing in soft tissue.[1]

References

  1. 1 2 3 4 Liepnieks, J. J.; Burt, C.; Benson, M. D. (2001). "Shoulder-pad sign of amyloidosis: Structure of an Ig kappa III protein". Scandinavian Journal of Immunology. 54 (4): 404–408. doi:10.1046/j.1365-3083.2001.00980.x. PMID 11555407. S2CID 7704329.
  2. 1 2 De Moura, C. G. G.; De Souza, S. R. P. (2004). ""Shoulder Pad" Sign". New England Journal of Medicine. 351 (25): e23. doi:10.1056/ENEJMicm040061. PMID 15602014.
  3. 1 2 Katz, G. A.; Peter, J. B.; Pearson, C. M.; Adams, W. S. (1973). "The Shoulder-Pad Sign — A Diagnostic Feature of Amyloid Arthropathy". New England Journal of Medicine. 288 (7): 354–355. doi:10.1056/NEJM197302152880709. PMID 4682948.
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