Author: Ajay Patel, MD
Co Author #1: Caroline A. Schepker, DO
Co Author #2: Alfred C. Gellhorn, MD
Senior Editor: Carolyn Landsberg, MD
Editor: Michael Beasley, MD, FAMSSM
35-year-old female with chest wall pain after a day of kitesurfing.
A 35-year-old female presented with left parasternal chest pain and left lateral shoulder pain that began shortly after a day of kitesurfing and waterskiing. She denied any acute trauma during these activities. Pain was described as sharp, deep, non-radiating, and was intermittent throughout the day, worsened when sleeping on the affected side. She also reported pain-limited left shoulder range of motion with flexion or abduction past 90 degrees with discomfort primarily just to the left of the sternum. She has not yet tried any medications or other therapies at the time of initial consultation.
Physical exam was remarkable for normal contours and alignment of the anterior chest wall and shoulders, with no deformities, ecchymosis, rash or abrasions. Palpation of the left shoulder elicited mild tenderness at the acromioclavicular (AC) joint. There was moderate tenderness to palpation at the sternoclavicular (SC) joint. There was full active and passive range of motion at the left shoulder. However, anterior sternoclavicular joint dislocation was noted with shoulder flexion and abduction. Sensation was intact to light touch bilaterally. Strength was 5/5 throughout the upper extremity. Jobe and O'Brien's tests were positive.
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