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A 66-year-old male presents with a three-month history of increasing right shoulder pain. He denies any trauma or prior shoulder problems, and has good rotator cuff strength. His medical history is significant for Crohn's disease which is controlled medically with prednisone therapy during flares. A current MRI image of his shoulder is shown in Figure A. What is the most likely diagnosis?
Chronic rotator cuff tendinopathy
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A 37-year-old severe asthmatic has been taking daily corticosteroids for twenty years and now reports 4 months of worsening left shoulder pain. He is unable to complete a full day of work due to the pain. A radiograph is provided in Figure A. Which of the following describes the pathogenesis behind this disease process?
Cell-mediated immune response inciting synovial hypertrophy and mononuclear destruction of cartilage
Humoral immune response following a systemic infection in an HLA-B27 positive individual
Hyperuricemia induced crystalline deposition within the synovial fluid
Cellular death of the subchondral bone following an interruption in the vascular supply
Bacterial seeding of the joint inducing polymorphonuclear cell destruction of the cartilage