Spikeball Palsy

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Spikeball Palsy - Page #1

Author: George Liras, DO, MS Co Author #1: Sarah Abdellatif, DO Co Author #2: Jocelyn Szeto, MD Co Author #3: Rehal Bhojani, MD Senior Editor: Joseph Chorley, MD Editor: Justin Mark Young, MD Patient Presentation: An 18-year-old right hand dominant male with no significant past medical history presented to the clinic for evaluation of right upper back and chest wall pain after an injury. History: The initial injury was 2 weeks prior to the office visit. The patient reported a popping sensation followed by a sharp pain in the upper back area while overhand spiking a ball during Spikeball. The pain radiated around the rib cage and into the upper chest. Pain was exacerbated by coughing, sneezing, and deep breathing. Patient tried over-the-counter NSAIDs as well as rehabilitation program by his school's athletic trainer for trapezius strain without relief. Patient also noted a drop of his shoulder and difficulty moving his arm. Physical Exam: Physical examination revealed right scapular winging and shoulder drop with tenderness over the pectoralis major, latissimus dorsi, right trapezius , right rhomboid, and thoracic paraspinal muscles. Right triceps strength was 4/5 along with weakness on shoulder shrug. Spurling's test was negative bilaterally. Drop arm sign was positive on the right. The patient's strength was 5/5 for supraspinatus, infraspinatus, subscapularis, Biceps and Deltoid bilaterally. No atrophy, prominent AC joint, prominent SC joint were appreciated. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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