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A Fall Into The Cyst-uation - Page #1
 

Author: Annika Lenz, MD
Co Author #1: Aaron Provance, MD
Co Author #2: NA
Co Author #3: NA
Senior Editor: Justin Mark Young, MD, FAMSSM
Editor: Yu-Tsun Cheng, MD

Patient Presentation:
The patient is a 14-year-old right hand dominant male with no prior shoulder pain who presented for consultation after injuring his right shoulder while skiing the previous day.

History:
He reported that he was attempting a 360 and landed on the lateral aspect of his right shoulder, which resulted in immediate pain and swelling. He was evaluated at an urgent care center where X-rays revealed concern for a physeal fracture of the proximal humerus, and he was placed in a sling. He was referred for definitive care. He described mild proximal humerus pain rated 2/10, which worsened with movement and improved with rest. He denied any prior injury or pain in the arm. He reported no other symptoms.

Physical Exam:
The right shoulder and clavicle showed no swelling, erythema, ecchymosis, nor deformity. The skin was intact, warm, and pink without signs of infection. There was tenderness to palpation over the medial and lateral proximal humerus. There was no tenderness over the sternoclavicular joint nor clavicle. Range of motion and strength were within normal limits, though pain occurred with resisted external rotation and elbow flexion. Distal neurovascular status was intact with brisk pulses and normal sensation and motor function.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415


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