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Shoulder Pain

UnFiNiShEd CaSe CoMe BaCk LaTeR

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History of Present Illness:

A 72-year-old male presents to the ED for 2 days of worsening right shoulder pain.  The pain is worse with movement and she can’t really lift her arm. She denies any injury, fever, chest symptoms or other complaints

Vital Signs & Physical Exam:

Vital signs are normal.  Physical exam is otherwise normal except for decreased ROM of the right shoulder and lateral tenderness.

Initial Differential Diagnosis: referred pain, infection, tendonitis, rotator cuff tear, cervical radiculopathy

Relevant Test Results:

  • EKG: none
  • Labs: none ordered
  • Imaging: See Below

 

QUESTIONS:

  1. What does the case image show?  
  2. What should you do next?  
  3. Want a 1-minute consult/tutorial on this case? 
  4. Want to know what happened with this patient?

SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT

 

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ANSWERS:

  1. What does the case image show?  The image shows calcific tendonitis.
  2. What should you do next?  Treat with pain meds.  Refer to ortho.
  3. Want a 1-minute consult/tutorial on this case?  See yellow area from sample page below.
  4. Want to know what happened with this patient?  See case conclusion below tutorial page.

1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook

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CASE CONCLUSION: We’ll just have to see

CASE LESSONS:

  1. Always
  2. Never
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