Not Your Bread And Butter Shoulder Pain

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Not Your Bread And Butter Shoulder Pain - Page #1

Author: Fouad Sayde, MD Co Author #1: Fouad Sayde, MD (Primary Author/Presenter) Co Author #2: Eric Makhni, MD Patient Presentation: 50 year old healthy male presents with right shoulder pain. Symptoms began 2 months ago, after a gym workout where he tried a new machine (chest fly). Three days later, started having achy right shoulder pain located in the lateral and superior shoulder. Pain was nonradiating. 2/10 at rest; 7/10 with activity (worse with bench press, overhead activities, and sleeping on affected shoulder); 8/10 at night. No neck pain, radicular symptoms, paresthesia, numbness, or tingling. Continued to go to the gym but reports associated shoulder weakness with overhead lifting. Ibuprofen provides moderate pain relief. Saw his PCP one month ago who prescribed Medrol dose pack, which relieved pain but not weakness. History: PMH: none PSH: left shoulder arthroscopy (2010) Allergies: none Meds: Ibuprofen 600 mg PRN Physical Exam: BP 103/63, HR 71, BMI 27 Neck: Full ROM; no tenderness; negative Spurling Right Shoulder: Inspection- no deformities, swelling, or erythema ROM- FF 170/170, abduction 170, ER 45 (left 45), IR T10 (left T9) Neers positive Hawkins positive Cross body negative Obrien negative Speeds negative Strength: Supraspinatus 4+/5; Infraspinatus 4+/5; Subscap 5/5; Champagne toast 4/5; Belly press, liftoff, and lag signs negative; Deltoid 3 heads intact and 5/5 Sensation intact in axillary, radial, median, and ulnar distribution Distal pulses intact Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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