Left Shoulder Pain In Baseball Player With Previous Humerus Fracture Repair

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Left Shoulder Pain In Baseball Player With Previous Humerus Fracture Repair - Page #3

Lab Studies: WBC 24.3 K/microL (Neutrophils 82%, Bands 3%), Hgb 12.7 g/dL, Platelet 373,000, Basic Metabolic Panel unremarkable. Alkaline phosphatase 293 IU/L. Erythrocyte Sedimentation Rate 41 mm/hr. C-Reactive Protein 160 mg/L. Lactate 0.8 mmol/L. Blood Cultures: No Growth Wound Culture: Oxacillin-Sensitive Staphylococcus Aureus Synovial Fluid Culture: Oxacillin-Sensitive Staphylococcus Aureus Other Studies: X-ray Shoulder (15 days post-injury): Widening of glenohumeral joint with humeral head depression, concerning for underlying effusion. Case Photo #4 CT Shoulder without contrast: Large aggressive-appearing collection centered around the glenohumeral joint extending into the deltoid and biceps. There was a sinus tract extending from the anterior humeral neck to the lateral upper arm. Case Photo #5 MRI Shoulder with and without contrast: Large abscess in the region of the deltoid as well as pyogenic arthritis of the shoulder with osteomyelitis and Brodie abscess with cloacal fistula. Necrotizing fasciitis would be of concern and definitely a consideration. Case Photo #6 Consultations: Medicine team for hospital admission Orthopedic Surgery Infectious Disease Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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