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Contributed By: Robert Schwer, DC

Case History: 55 yo right handed male with right shoulder pain

Some diagnoses you should be considering are shoulder sprain, shoulder separation, tendinitis/bursitis, rotator tear. Examination: Vital signs were all within normal limits. Neurologic review of upper extremities revealed 2+ reflexes throughout. Sensory evaluation was within normal limits. Strength testing revealed 4/5 weakness of right shoulder flexion, abduction and external rotation. Right shoulder flexion was 150 degrees. Abduction was 140 degrees. Internal and external rotation were within normal limits. All produced end range pain. There was acute tenderness over the rotator tendon. Isolated testing of supraspinatus produced immediate give way weakness with increased pain. Tender trigger points were found in both supraspinatus and infraspinatus. Orthopedic evaluation of the neck was unremarkable. Question: What is your working diagnosis at this point? What other tests if any would you order? Not a registered user of ChiroCredit.com? Click here to register for free and take your first hour for FREE.

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