PMC10115201_01
Preoperative right shoulder X-ray of the patient showing severe arthritic changes, superior migration, and subchondral bone cyst, finding suggestive of advanced osteoarthritic changes and rotator cuff arthropathy of the right glenohumeral joint.
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The preoperative image shown in Figure 1.
Preoperative right shoulder MRI with prominent osteophytes of the glenoid, increased signal at the supraspinatus tendon, and prominent bone marrow edema, and subchondral cyst.
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Since there were signs of rotator cuff arthropathy, the patient had a right shoulder MRI without contrast (Figure 2), which showed severe osteoarthritic changes of the right glenohumeral joint, including narrowing of the joint space, osteophytes, abnormal signal intensity of visualized bone consistent with bone marrow edema, and multiple subchondral cysts.
Intraoperative findings of severe black discoloration of the soft tissue (ochronosis), a striking feature of Alkaptonuria. (A) Soft tissue ochronosis. (B) Humerus head cut with severe blackish discoloration.
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In addition to the standard surgical procedure for reverse arthroplasty, a remarkable intraoperative finding of soft tissue ochronosis is observed in Figure 3.
Postoperative radiography of the reverse procedure, with the humerus stem, head, and components well fixed and in a good position and orientation.
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A postoperative X-ray showed well-positioned and aligned components in Figure 4.