Medicine:Shoulder pad sign

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Shoulder pad sign
Shoulder Pad Sign 2.jpg
Shoulder pad sign
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. 1.0 1.1 1.2 1.3 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. 
  2. 2.0 2.1 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. 3.0 3.1 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.