An elderly man presents with gradually increasing pain and stiffness of one shoulder over several months. Examination shows marked wasting of the deltoid and scapular muscles, grossly restricted glenohumeral movement, and strikingly little swelling, effusion, or abscess formation. Radiographs show marginal erosions with osteoporosis. Which variant of tuberculous shoulder arthritis does this represent?

• A Caries sicca ✓
• B Caries exudata
• C Milwaukee shoulder syndrome
• D Adhesive capsulitis of infective origin

Explanation

Caries sicca is the dry form of tuberculous arthritis of the shoulder, typically seen in older adults. Granulation tissue causes fibrinous exudate that organizes into adhesions rather than forming frank pus, so there is minimal swelling, little or no cold abscess, and pronounced restriction of movement with muscle wasting. Caries exudata is the opposite, exudative form with abscess and sinus formation.

Reference: Campbell's Operative Orthopaedics, 14th ed.

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Written and medically reviewed by the StethoPrep medical team.