Persistent Right Shoulder Pain - Page #1

Author: Sammy Wu, MD
Co Author #1: Scott Klass, MD
Co Author #2: Christopher Visco, MD
Co Author #3: Christopher Ahmad, MD
Senior Editor: Rachel Coel, MD, PhD
Editor: Namita Bhardwaj, MD, MS, MPH

Patient Presentation:
A 42-year-old male softball player/weightlifter presented with right shoulder pain at the mid to distal right clavicle, described as a constant, burning sensation and exacerbated by overhead activity, cross arm adduction, and pushing up.

He had significant surgical history, including repair of a right shoulder superior labrum anterior to posterior tear in 2010 that occurred after sliding into a base during a softball game. In 2019, he also had a right shoulder acromioplasty, acromioclavicular joint debridement and distal clavicle resection for persistent shoulder pain due to acromioclavicular joint arthritis and impingement. In 2020, he had a repeat right shoulder subacromial decompression with acromioplasty. He had a history of 3 acromioclavicular joint steroid injections.

Physical Exam:
Inspection: No significant swelling or discoloration was appreciated.
Palpation: Tenderness to palpation over the right acromioclavicular joint and distal clavicle.
Range of motion: Full with presence of mild right scapular dyskinesis.
Strength: 5/5 in upper extremities bilaterally.
Sensation: Intact to light touch in upper extremities bilaterally.
Special tests: Positive for horizontal cross body adduction test.

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