Acute Traumatic Shoulder Pain From Recreational Football Injury - Page #1

Author: Michael Villasin, MD, MPH
Senior Editor: Rahul Kapur, MD
Editor: Moira Davenport, MD

Patient Presentation:
19 year old right hand dominant male presents with left shoulder injury playing recreational football the night prior.

Patient fell on an outstretched hand and his left arm hyperextended backwards in mild abduction. He felt a pop and tearing sensation. He was not wearing any protective equipment at the time. He had 8-10 minutes of numbness and tingling in his left arm which has since resolved. He continues to have pain over his left pectoralis and proximal bicep. He denies prior injury or pain at night. He tried ice and ibuprofen with minimal improvement.

Physical Exam:
Left upper extremity exam showed ecchymosis along the medial aspect of the upper arm with tenderness on the lateral pectoralis and proximal biceps. He had medialization of the bulk of the pectoralis major muscle with a drop nipple sign. In abduction and external rotation, there was clear asymmetry of the axillary fold Case Photo #1 . He had pectoralis major muscle spasm on flexion and adduction.

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