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A Curveball Case Of Armpit Pain In A Pitcher - Page #1
 

Author: Bassem Hanna, MD
Co Author #1: Muhammad Rizwan, DO
Co Author #2: Yasmin Dhar, MD
Co Author #3: Mooyeon Oh-Park, MD
Senior Editor: Christian Fulmer, DO, FAMSSM
Editor: Derrick Miller, MD

Patient Presentation:
Right infra-axillary pain in a 19 year old male

History:
A 19-year-old male baseball player presented to the athletic training room for assessment of right-sided "armpit pain." He reported pitching 5 days prior when he felt a sudden popping sensation under his right armpit. This was shortly followed by pain in the area which significantly worsened when attempting to pitch again, most notably during the late-cocking phase. Afterwards, he noticed a small lump appeared around the area of his pain. This lump was initially tender to touch and swollen. The athlete rested and applied ice to the area over the span of 2 weeks until the pain and swelling improved. He attempted to pitch, which again triggered the same pain he had before. He continued to report difficulty and weakness with pitching and denied numbness, tingling and radiating symptoms.

Physical Exam:
The patient had a visible lump in the right infra-axillary region. There was no erythema and a small amount of swelling. On palpation, the lump felt like a soft mass and caused the patient discomfort. The lump was slightly mobile. The patient had a full active range of motion of his right shoulder and upper extremity. There was some discomfort with resisted right arm adduction and shoulder extension. Provocative testing for shoulder impingement, acromioclavicular joint pathology, glenohumeral and labral injuries were negative. Sensation to light touch was equal and intact bilaterally. Radial pulse was equal and intact bilaterally.

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