USMLE 2 Question 25

A 48 year old female teacher has an x-ray taken because of a recurrent dry cough. It is noted incidentally that there is sclerosis, destruction and fragmentation. On examination it is noted that she has decreased pain sensation over her shoulder joint and upper limb area.

These features are suggestive of:

a) juvenile rheumatoid arthritis
b) syringomyelia
c) epidermolysis bullosa
d) bronchial carcinoma
e) infectious mononucleosis








ANSWER
The correct answer is B



Explanation
In syringomyelia, decreased pain sensation and impaired position sense contribute to the massive destruction of the the shoulder.

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