Shoulder

Question 1

A 24-year-old volleyball player presents with pain in the shoulder which prevents her from serving overhead. On examination, Jobe test is positive along with the impingement test. X-ray is normal. MRI shows no tear.

Answer 1

Supraspinatus tendinitis (Shoulder impingement syndrome)

Question 2

A 38-year-old female badminton player complains of right shoulder pain which prevents her from playing overhead shots. She is unable to abduct the arm fully. On examination, there is limited abduction of the right shoulder. Hawkins-Kennedy and Codman tests are positive. X-ray shows calcification in the subacromial space.

Answer 2

Rotator cuff injury

Question 3

A 23-year-old baseball pitcher presents with left anterior shoulder pain. The pain is worse with pulling or lifting heavy objects. On examination, there is tenderness 3” below the anterior portion of the acromion. Speed and Yergason tests are positive. Ultrasound shows calcification and edema in the affected structure.

Answer 3

Bicipital tendinitis

Question 4

A 68-year-old chronic male smoker presents with pain in the left shoulder. On examination, there is fullness in the left supraclavicular region. Chest x-ray shows a mass in the apex of the left lung. Biopsy of the mass shows a squamous cell carcinoma.

Answer 4

Pancoast tumor

Question 5

A 63-year-old female presents with pain over the lateral aspect of the right shoulder. On examination, there is marked tenderness just below the lateral aspect of the acromion. Dawbarn’s test is positive. No other tests were done.

Answer 5

Subacromial bursitis

Question 6

A 54-year-old female presents with a painful right shoulder. The pain is worse at night and with movement. On examination, there is restricted ROM in all planes and any active movement causes pain. Mazion maneuver causes pain as well. MRI shows marked thickening of the joint capsule.

Answer 6

Adhesive capsulitis (Mazion’s maneuver is the opposite of Dugas– move shoulder up instead of down)

Question 7

A 23-year-old basketball player complains of vague shoulder pain and a clicking sensation every time he raises his hand above his shoulder. O’Brien’s test is positive. MRI shows a tear in the glenoid labrum.

Answer 7

SLAP lesion

Question 8

A 15-year-old baseball player complains of lateral shoulder pain after throwing. On examination, there is tenderness over the lateral proximal humerus. X-ray shows slight widening of the lateral part of the proximal humeral epiphysis.

Answer 8

Little leaguer’s shoulder