Acute Paresthesias In A High School Football Player - Page #1

Author: Will Paulson, MD
Editor: Guy Nicolette, MD

Patient Presentation:
AB is a 17 year old otherwise healthy male who presented to our clinic five days after sustaining a right shoulder injury in a high school football game.

The patient, a linebacker, attempted a tackle by diving into his opponent, impacting his right shoulder on the opponent’s thigh. The patient immediately felt the onset of numbness and weakness in his right arm. He sat out for a couple minutes prior to the feeling returning to his arm. He completed the game with minimal pain in his shoulder. Since that time he has experienced intermittent right shoulder numbness and pain with movement associated with mild weakness. He denies left sided symptoms or neck pain.

Physical Exam:
Right upper extremity
Inspection: no ecchymosis, misalignment, atrophy, or other abnormalities.

Palpation: generalized tenderness to palpation over deltoid diffusely. No palpable abnormalities in clavicle or acromioclavicular joint.

Range of motion: full passive and active range of motion of arm. Some pain at extreme abduction.

Strength: 5/5 strength with all muscle testing.

Special testing: Yergason’s, and apprehension negative. Neer’s and Hawkin’s positive for pain. Cross body adduction negative for pain.

Neurologic: no sensory deficits. 2/4 deep tendon reflexes at biceps, brachioradialis, triceps. Subjective paresthesias in proximal upper arm with full abduction.

Neck: full range of motion. No cervical tenderness. Spurling’s negative.

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NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.

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