Author: Michael Moreland, DO
Co Author #1: Margaret Gibson, MD
A 16 year old right hand dominant male presented to an urgent care one hour after sustaining a right shoulder injury during football practice.
He was carrying the ball when he tripped landing directly on his right shoulder; then, a lineman fell on top of him. He felt a pop and had immediate pain throughout his shoulder associated with parasthesia along the anteromedial aspect of his neck. His parasthesia resolved prior to arrival to urgent care but noted continued shoulder pain. Radiographs were obtained which demonstrated a first rib fracture with callus formation. This was felt to be the consistent with his injury at the time so he was given a sling for comfort and discharged with follow-up in the Sports Medicine Clinic. He denied ever having difficulty breathing or swallowing, neck pain or color/temperature change of the right extremity. He also denied any previous injury or trauma to the shoulder.
Follow-up exam in the sports medicine clinic revealed him to be well appearing, talking in full sentences without difficulty. Exam of the right shoulder revealed no bruising or erythema. There was mild swelling over the right sternoclavicular (SC) joint associated with asymmetry and inability to definitively palpate the right SC joint. He had limited range of motion in flexion and extension of his neck and demonstrated 5/5 strength in his rotator cuff muscles and intact motor function distally. He had no pain with palpation over the first rib bilaterally.
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