β£XR of a destructive shoulder. What are the possible Ddx?Infection - TBTrauma - severe malunion and collapseAVN of shoulderNeurological - Charcot'sβ£What is Milwaukee Shoulder?it is a destructive, calcium hydroxyapatite crystalline arthropathyAssociated with Rotator cuff defects and histology will have numerous aggregates of calcium hydroxyapatite crystalsβ£How do they present?Rapid onset of painful swellingβ£Investigations?XR - OA features with rapid destructionAspiration - Haemorrhagic fluidβ£What is a special stain to diagnose Milwaukee shoulder?Special stain = Alizarin Red S Stain for Calcium Hydroxyapatite CrystalsCan sometimes also contain CPPD crystals (positive birefringent rhomboid crystals) [Mixed Calcium phosphate Deposition Disease]β£Mx?SupportiveRest, NSAIDSColchicine shown to be effectivePT to maintain ROM.