Preventing A Photo Finish? A Mysterious Neck Mass In A Track Athlete

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Preventing A Photo Finish? A Mysterious Neck Mass In A Track Athlete - Page #1

Author: Allyson DiMagno, MD Co Author #1: Stephen Simons, MD Senior Editor: Drew Duerson, MD Editor: Alexei (Alec) DeCastro, MD Patient Presentation: The patient is a 23-year-old male collegiate athlete without any significant medical history who presented with a left-sided anterior neck mass located just superior to his clavicle. History: The patient reported that the mass has been present for several years, but over the past few weeks, he developed mild discomfort with overhead activities such as reach, bench press, and push-ups. He denied any change in the size of the mass or any prior history of trauma, fractures, weight loss, chest pain, shortness of breath, numbness or tingling, weakness, or color changes to the left arm Physical Exam: The patient's vitals were within normal limits with a blood pressure of 121/75 and a pulse of 65. He was well-appearing and in no acute distress. On examination, a pulsatile neck mass superior to the left clavicle was noted that was mildly tender to palpation. There was no thrill, lymphadenopathy, or mass on the right side. His heart has a regular rate and rhythm and there was no murmur in seated, supine, or with Valsalva maneuver. The patient had full range of motion of his bilateral upper extremities and 5/5 strength with shoulder abduction and flexion. The elevated arm stress test was 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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