Shoulder pad sign

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Shoulder pad sign
Synonyms	N/A
Pronounce	N/A
Specialty	Rheumatology, Oncology
Symptoms	Swelling over the shoulder area
Complications	N/A
Onset	N/A
Duration	N/A
Types	N/A
Causes	Primary amyloidosis, Multiple myeloma
Risks	N/A
Diagnosis	Physical examination, Imaging studies, Biopsy
Differential diagnosis	Lipoma, Lymphoma, Soft tissue sarcoma
Prevention	N/A
Treatment	Depends on underlying cause; may include chemotherapy, radiation therapy, or surgical intervention
Medication	N/A
Prognosis	Varies based on underlying condition
Frequency	Rare
Deaths	N/A

Clinical sign in medicine

The shoulder pad sign is a clinical manifestation characterized by the presence of soft tissue swelling over the shoulders, giving the appearance of shoulder pads. This sign is most commonly associated with amyloidosis, particularly primary amyloidosis (AL amyloidosis), where there is deposition of amyloid protein in the soft tissues.

Pathophysiology

The shoulder pad sign occurs due to the deposition of amyloid proteins in the soft tissues around the shoulders. Amyloid is an abnormal protein that can accumulate in various tissues and organs, leading to dysfunction. In the case of the shoulder pad sign, the amyloid deposits cause a noticeable swelling over the shoulders, which can be palpated and sometimes seen as a bulging mass.

Clinical significance

The presence of the shoulder pad sign is a significant clinical indicator of systemic amyloidosis. It is important for clinicians to recognize this sign as it can aid in the early diagnosis of amyloidosis, which is crucial for the management and treatment of the condition. The shoulder pad sign is not exclusive to amyloidosis but is highly suggestive of it, especially when accompanied by other symptoms such as carpal tunnel syndrome, macroglossia, and nephrotic syndrome.

Diagnosis

The diagnosis of amyloidosis in the presence of the shoulder pad sign involves a combination of clinical evaluation, laboratory tests, and imaging studies. A biopsy of the affected tissue, stained with Congo red stain, can confirm the presence of amyloid deposits. Additional tests may include serum and urine protein electrophoresis, immunofixation, and genetic testing to determine the type of amyloidosis.

Treatment

Treatment of amyloidosis with the shoulder pad sign focuses on managing the underlying cause of amyloid deposition. In primary amyloidosis, treatment options may include chemotherapy, autologous stem cell transplantation, and novel agents such as proteasome inhibitors and monoclonal antibodies. Supportive care is also important to manage symptoms and improve quality of life.

See Also

• Amyloidosis
• Primary amyloidosis
• Carpal tunnel syndrome
• Macroglossia
• Nephrotic syndrome