A 10 Year-old With A Winged Scapula--but Not From What You Might Think

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A 10 Year-old With A Winged Scapula--but Not From What You Might Think - Page #1

Author: Eric Bowman, DO Co Author #1: Thomas L. Pommering, DO Division Chief, Sports Medicine Nationwide Children's Hospital Assistant Clinical Professor, Departments of Pediatrics and Family Medicine, The Ohio State University College of Medicne Columbus, Ohio Patient Presentation: A 10 year-old female who presented with a right scapula that was getting progressively more winged over the past year. History: A 10 year-old female involved in soccer, basketball, and swimming presented with a right scapula that was getting progressively more winged over the past year. It became a problem when she was doing her essential fitness test in gym class. She was only able to do 15 push-ups when her shoulder felt like it was not working. No injury or trauma has ever been reported. She has never had any numbness, tingling, gross weakness, or neck pain. She is right hand dominant. Physical Exam: She is an awake, alert, pleasant healthy appearing 10 year-old in no acute distress. Her neck and back have full range of motion without spinal or paraspinal tenderness. She has a negative Spurling, no scoliosis, kyphosis, nor lordosis. She has no atrophy around the shoulder girdle, but obviously wings on the right scapula at rest. She protracts less well on the right side when asked to go against resistance. There is no mass, redness, warmth nor rash noted around the shoulder girdle. When comparing the right shoulder to the left, she has full range of motion, relatively normal rotator cuff exam without pain, no atrophy, and her neurovascular exam is intact, including biceps and triceps reflexes at 2+/4, and sensory exam symmetric. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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