An Uncommon Diagnosis For A Common Shoulder Pain In A High School Football Player

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An Uncommon Diagnosis For A Common Shoulder Pain In A High School Football Player - Page #1

Author: Kiet La, MD Co Author #1: Patrick Mularoni, MD Senior Editor: Kristine Karlson, MD, FAMSSM Editor: Sam Hwu, MD Patient Presentation: Right shoulder pain History: A 15 year-old male football player presented for evaluation of right shoulder pain. His initial injury was about seven months ago when he fell directly on his right shoulder during a football game. He had a concurrent left ankle sprain at that time, and sought care only for his left ankle and not for his right shoulder. He remembered having significant pain over his right anterior shoulder for the next two weeks. He consistently had pain with lifting his right arm past 90 degrees or lifting heavy objects. He sought care due to difficulty keeping up with football practices, training, and weight lifting after high school football started three weeks before he presented to our clinic. He denied numbness or tingling. He denied other injuries, repeated injury, or previous surgery of the right shoulder. Physical Exam: Visual inspection of the right shoulder was unremarkable. Palpation revealed tenderness over the right acromioclavicular joint and the acromion. Active range of motion was limited to 90 degrees abduction and 90 degrees anterior flexion secondary to pain. Passive range of motion was limited to 110 degrees abduction and 110 degrees anterior flexion. External rotation was painful. Empty can, O’Brien, and posterior apprehension tests were positive. Neer’s test and lift-off test were negative. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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