A Weighty Diagnosis: Chest Mass In A Young Weightlifter

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A Weighty Diagnosis: Chest Mass In A Young Weightlifter - Page #1

Author: Chelsea Salas-Tam, MD Co Author #1: R. Robert Franks, DO Senior Editor: Heather Rainey, MD Editor: James Toldi, DO Patient Presentation: A 24 year old male recreational weightlifter with no significant past medical history presented with right-sided chest pain after weightlifting. History: 1 month ago he was doing a chest press with heavier weights and subsequently had pain at his right chest. He did not feel a pop. The next day he noticed a lump at his right chest and axilla that he attributed to his lifting injury. His PCP ordered an ultrasound of the right shoulder which was suspicious for a rotator cuff tear and possible pectoralis tendon rupture and referred him to sports medicine. The mass slowly increased in size over the weeks before his visit. On presentation, he denied numbness and tingling in the extremity. He denied fevers, chills, night sweats, or unintentional weight loss. Physical Exam: His chest was grossly asymmetric on visual inspection with the right side appearing much larger. Upon palpation there was a firm, nonmobile tender mass along the right chest extending to the right axilla. There were no overlying skin changes. He exhibited full painless range of motion of the shoulder bilaterally with abduction and elevation to 180 degrees. Strength was 5/5 in the deltoids, biceps, triceps, wrist extensors, wrist flexors, and intrinsic hand muscles. Sensory was intact to light touch throughout the C5-T1 dermatomes of the right upper extremity. He was overall neurovascularly intact. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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