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Aspirate to exclude infection; crystal ID requires special techniques (alizarin red S)
Suspect BCP with rapidly destructive shoulder OA, hydroxyapatite on imaging
Manage pain and inflammation (NSAIDs, intra‑articular steroids, aspiration)
Address rotator cuff insufficiency and function (PT, assistive devices)
Follow for recurrence and contralateral involvement
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Basic Calcium Phosphate (BCP) Deposition — Milwaukee Shoulder
Elderly woman with destructive shoulder arthropathy and large effusions. Consider BCP (hydroxyapatite) crystals; exclude infection and tailor therapy.
⏱️ 110s
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🌱 Beginner Level — 0 / 50
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How to Play
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Goal: Arrange steps in the correct order before time runs out.
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Pick: Click Pick to add a step; each slot is checked against the correct pathway.
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Scoring:
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+10 for a first-try correct step
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–5 for wrong (irreversible for that slot)
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–20 if the wrong step is harmful
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–2 for using a hint
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Tiers: 🏆 Mastery · 🥇 Expert (≥80%) · 🥈 Proficient (≥60%) · 🥉 Intermediate (≥40%) · 🎖️ Novice (≥20%) · 🌱 Beginner (<20%).
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Undo: Removes a step but doesn’t restore full credit if it was missed.
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Feedback: 🎯 Correct · 🚫 Wrong · ⚠️ Harmful · 💡 Hint.
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End: ✅ Case Complete or ⌛ Time Up → summary with score, tier, mistakes, and references.
