Case 3

A 53-year old woman presents with pain and dysfunction of her right shoulder. She has had symptoms for the past three months and denies any injury. She feels that the problem is getting worse and is now having trouble with day-to-day activities such as washing her hair and reaching overhead. The pain is dull and constant and worse with attempted arm elevation or if she lies on the right side in bed at night. She has no other joint problems and is healthy other than non-insulin dependent diabetes that is currently well-controlled with diet and medication.

When you examine her, you notice a difference in the motion of the right and left shoulders. In particular, she lacks internal rotation and abduction of the right shoulder.

Shoulder_woman1.jpg Shoulder_woman3.jpg

Image credit: G.M. Taylor

Questions for discussion:

  1. What is the most likely diagnosis based upon this information?
  2. What anatomic structures may be abnormal in this individual?
  3. What imaging would be helpful and what would you expect to see?

 


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