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Differential diagnosis for shoulder pain (Get help here)
Differential diagnosis for shoulder pain.What are your three diagnostic considerations in order of priority? Press pause and list your answers resume when you’re ready to receive feedback. Shoulder pain is a common complaint in primary care. This patient has many of the features of a rotator cuff syndrome. rotator cuff disorders range from impingement and compression of the rotator cuff tendons and the subacromial bursa between the greater tubercle of the humeral head and the lateral edge of the acromion process. To full tears of the rotator cuff. The patient has typical gradual onset of a lateral and anterior shoulder pain with repetitive overhead motion. He has pain at night when sleeping on the affected side. At times he notices a grating sound with overhead movement. He does not report weakness however, which is common. on physical examination. The patient has positive findings on all five recommended test the painful arc tests to provoke pain the three strength tests internal rotation, external rotation and drop arm test and the composite test for external rotation resistance. The patient has snow in pre spine as atrophy on inspection of the posterior shoulder he has fairly intact shoulder range of motion. He can still hold his arm somewhat elevated to shoulder level, so impingement is more likely than a complete tear. A complete tear often results in a shrug appearance from inability to raise the arm this usually is caused by rupture of the super spy naters and infra spine as tendons.
There are some tenderness over the bicipital tendon Bicipital tendonitis can accompany rotator cuff disorders, but the history and examination findings point to the primary and more extensive involvement of the rotator cuff. Patients with acromioclavicular arthritis typically reported pain over the acromioclavicular joint and pain with lifting over the ACH joint area. A Chromeo clavicular arthritis is more common in patients older than 50. Patients often have a history of a direct fall onto the shoulder involvement in sports or occupations involving overhead lifting or previous injury such as shoulder or acromioclavicular. Separation can lead to inflammation and degeneration of cartilage lining the acromioclavicular joint narrowing of the acromioclavicular joint space and even formation of osteophytes in patients with acromioclavicular arthritis reaching across the body, even to put on a seatbelt may cause tenderness and pain especially at the front and top of the shoulder examination may reveal swelling over the acromioclavicular joint. There is localized acromioclavicular joint tenderness to palpation which is not present in this patient pain with adduction on the crossover or cross body adduction test. When the patient lives send a duck’s the arm across the chest is typical of acromioclavicular arthritis however, shoulder range of motion is preserved in acromioclavicular arthritis, which is not the case in this patient. Although his crossed body adduction overhead and behind the back movements are impaired (Get help here)