Dog Gone Painful: An Unusual Case Of Acute Shoulder And Chest Pain

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Dog Gone Painful: An Unusual Case Of Acute Shoulder And Chest Pain - Page #1

Author: Keegan McClary, MD Co Author #1: Christopher Hogrefe Senior Editor: Benjamin Oshlag, MD, MS Editor: Marc Hilgers, MD, PhD, FAMSSM Patient Presentation: RK is a 44 year old healthy right-handed female who presents to an outpatient Sports Medicine clinic for evaluation of left shoulder and chest pain. History: Eight days prior she was pulled forward by her leashed dog, producing pain in her left shoulder and chest. She had initially presented to the local Emergency Department and underwent a cardiac workup that was negative, as were chest and shoulder plain films. Her exam revealed anterior shoulder and chest wall tenderness, and she was diagnosed with costochondritis. Instructions for treatment with ibuprofen were provided at discharge. She then returned to the ED just over one week later for acute worsening of her pain. Her exam at that time revealed possible left shoulder pathology with positive Hawkins and Neer testing. She was discharged with a diagnosis of a rotator cuff tear and referred to Sports Medicine for follow-up. At this follow-up she notes swelling and erythema near the left sternoclavicular joint and pain that reaches 10/10 on the pain scale. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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