High School Football Player With Shoulder Pain And Winged Scapula

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High School Football Player With Shoulder Pain And Winged Scapula - Page #1

Author: Kyle Samyn, DO, MS Co Author #1: Nicholas Moore, MD Senior Editor: Heather Rainey, MD Editor: Meghan (Mimi) Raleigh, MD, MS Patient Presentation: 16-year-old male high school football player presented to clinic with left shoulder pain History: Three weeks prior, he was supine after a tackle and an opposing player's elbow fell onto his left upper back. Since then, he experienced nonradicular pain at the base of his neck and left posterior shoulder. His pain was described as a constant "ache." His pain was worse with lifting objects overhead and with prolonged standing with his arm at his side; pain was improved with rest, ice, and heat. He also noted reduced range of motion in shoulder abduction and flexion. He denied any previous injury or surgery. He also denied any upper-extremity sensory changes or any distal upper-extremity weakness. Physical Exam: Inspection-no swelling or ecchymosis. Trapezius muscle atrophy noted without deformity. Left scapular dyskinesis (rotated down and laterally). Case Photo #1 , Case Photo #2 . Active Range of Motion -120 degrees forward flexion, 100 degrees abduction, 70 degrees external rotation, internal rotation to T6. Strength-5/5 deltoid, 5/5 bicep. 5/5 supraspinatus, 5/5 infraspinatus, 5/5 subscapularis. Neurovascular-2+ radial pulses, sensation intact to light touch throughout radial, medial and ulnar distributions. Special Tests: Negative Hawkins and Neers. Stability tests were negative (Load/Shift, Sulcus, and Apprehension/Relocation). Further special tests were all negative (O'Brien's, crank, Speeds test, Yergasens, compression/rotation crossarm). Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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