Shoulder pad sign
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 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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