Author: Melissa Jackels, BS, PSM
Co Author #1: Justin Mark J Young MD
Co Author #2: S Nick Crawford MD
Senior Editor: Joseph Chorley, MD
Editor: Justin Mark Young, MD

Patient Presentation:
The patient was a 21-year-old defensive lineman who presented with right shoulder pain and shortness of breath.

History:
The patient was a 21-year-old defensive lineman who presented with right shoulder pain and shortness of breath after landing on his shoulder while tackling another player during a spring football scrimmage. The patient was removed from the game and reported shortness of breath, light headedness, and numbness and tingling of the upper arm and shoulder, and residual pain. On evaluation, he was found to have tenderness to palpation over the right AC joint with mild lifting of the clavicle. He was sent home with ice and an arm sling. The patient reported back later that evening with worsening pain and received imaging. He endorsed that range of motion was limited by increased pain and denied any recurrent shortness of breath, numbness, or tingling. He had a past medical history significant for panic attacks and multiple stinger injuries over the past several years.

Physical Exam:
General: Initially patient was tearful and upset, but as time passed he was breathing comfortably
Neck: Supple, normal range of motion
Cardiac: Regular rate and rhythm, no murmurs
Lungs: Clear to auscultation
HEENT: Normocephalic, atraumatic, no conjunctival injection
Extremities: Right shoulder in sling and wrapped with ice, limited range of motion and tenderness to palpation over right AC joint with mild lifting of the clavicle
Skin: No rashes or skin lesions, normal color

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