The Shoulder That Blew A Fuse

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The Shoulder That Blew A Fuse - Page #1

Author: Makenna Brezitski, MD Co Author #1: Jessica Butts, MD Senior Editor: Kevin Gray, MD Editor: Chris Clemow, MD Patient Presentation: A 23-year-old female recreational athlete presented to our clinic with longstanding right shoulder pain. History: She presented with a 9-year history of atraumatic, progressive, right shoulder pain located superolaterally and anteriorly with posterior radiation. Her pain was exacerbated by any overhead motion. She had progressed from intermittent pain with movement to near constant pain and symptoms with nearly all of her activities of daily living. Her only medications included meloxicam and Plaquenil as prescribed by her rheumatologist for ANA+ polyarthralgia, which did not reduce her reported symptoms. Physical Exam: Vital signs within normal limits. Right shoulder has no visible deformity. Positive tenderness to palpation over the acromioclavicular joint and lateral shoulder, with diffuse peri-scapular tenderness and trapezius spasm. She had full range of motion in all planes with appreciable scapular dyskinesis and anterior/superior pain at 160°of abduction and flexion. Strength 5/5, symmetric in all planes. Special testing revealed a negative empty can, Neer’s, O’Brien’s, and cross body adduction, but all with provocation of reported anterior/lateral pain. She was neurovascularly intact. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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