An interesting case of vanishing shoulder

Description 

A 37-year-old woman with progressive difficulty in using her left arm and with discomfort in the left shoulder was evaluated. Her complaints were of insidious onset and progressed over a period of 3 months. She had a soft shoulder and passive movements in the left shoulder were increased in all ranges, with internal and external rotation of 180° each (figure 1A,B). Active abduction was up to  90°. Radiographs of the shoulder demonstrated the absence of humeral head and a small sliver of bone, reminiscent of the greater tubercle (figure 1C). She was evaluated for neuropathic arthropathy, infection, neoplastic, metabolic and endocrine causes of osteolysis using appropriate blood tests and imaging techniques. Her blood parameters were normal. MRI confirmed absence of the proximal humerus and resorption and expansion of the glenoid cavity (figure 2A,C). A syrinx extending from the C2–D9 spinal region (figure 2C,D) was incidentally...

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