Double Trouble: Persistent Shoulder Pain In A Young Female

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Double Trouble: Persistent Shoulder Pain In A Young Female - Page #3

Lab Studies: No labs were obtained. Other Studies: Right shoulder radiograph: Chronic acromioclavicular joint injury. Otherwise normal. Case Photo #1 Magnetic resonance arthrogram: Normal. C-Spine radiographs: Straightening of cervical lordosis. No evidence of spinal canal stenosis. Case Photo #2 Cervical spine MRI: No degenerative changes, disc herniation, or stenosis. Right upper extremity electromyography/nerve conduction study: Normal. Magnetic resonance angiogram of the right upper extremity: Patent arterial and venous vasculature at rest and with overhead positioning. Case Photo #3 Anterior scalene block: Provided partial relief; however, paresthesia persisted with palpation of the pectoralis minor muscle. Pectoralis minor block: 95% symptomatic relief. Consultations: Vascular Surgery was consulted for suspected thoracic outlet syndrome despite negative imaging. Interventional Radiology subsequently performed a neuromuscular block. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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