The Case Of Traveling Rings And Nighttime Shoulder Pain

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The Case Of Traveling Rings And Nighttime Shoulder Pain - Page #3

Lab Studies: Notable labs: Ferritin 34, Vitamin D 25, Free T3 index low at 76.4. Normal studies: CMP, CBC, Magnesium, Phosphorous, ESR/CRP, DHEAS, LH, FSH, prolactin, TSH, estradiol, testosterone. Other Studies: X-ray right shoulder (6/2019): Normal alignment with no acute fracture. No degenerative changes. Case Photo #1 Case Photo #2 Case Photo #3 MRI right shoulder (4/2020): Focal bone marrow edema along the proximal humerus measuring 3.3 cm without acute fracture consistent with high-grade bone stress injury. Tendinopathy of the supraspinatus, subscapularis and long head of the biceps. Case Photo #4 Case Photo #5 MRI right shoulder (8/2020): Unchanged bone marrow edema at the humeral diaphysis with periosteal reaction. Linear signal at the anteromedial cortex consistent with fracture or osteoid osteoma. Case Photo #6 CT right shoulder (9/2020): 4mm lucency of the superficial cortex of the anterolateral medial proximal humeral shaft with endosteal sclerosis and a small calcified nidus consistent with an osteoid osteoma. There is minimal periostitis and a lucency extending from the shaft into the lesion that is likely a vascular channel. Case Photo #7 Consultations: The case was discussed with the musculoskeletal radiologists. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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