Shoulder pad sign

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]

Shoulder pad sign
Shoulder Pad Sign.jpg
Shoulder pad sign (A and B). Technetium-99m (99mTc)-pyrophosphate scan without any significant uptake in shoulders (C)
Differential diagnosisAL amyloidosis


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. 


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 Metasyntactic variable, which is released under the 
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