An Unusual Cause Of Anterior Shoulder Pain - Page #1

Author: Ethan Rand, MD
Co Author #1: James Wyss, MD, PT Department of Physiatry Hospital for Special Surgery
Editor: Michael Broton, MD

Patient Presentation:
A 32 year-old male with a history of benign lipomatosis, presented to the outpatient clinic complaining of left anterior shoulder pain that began ten months prior.

The pain was insidious, aching, occasionally sharp in nature, and 8/10 in severity. Pain was worse with external rotation of the shoulder, as well as with overhead activities. Symptoms were alleviated with limiting range of motion. He reported some subjective weakness, but denied any paresthesias or neck pain.

Prior to developing shoulder pain, he regularly participated in recreational weight lifting.

Physical Exam:
Diffuse lipomas were seen over his bilateral upper extremities and around his torso. Active range of motion of the shoulder was minimally limited with internal and external rotation. Cervical range of the motion was normal and painless. Neer’s test, Hawkin’s test, lift-off test, and painful arc were positive, and Spurling's maneuver was negative. Neurologically, his sensation and strength were normal throughout bilateral upper extremities, except strength testing was limited by pain with shoulder external rotation.

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