Case History:

73 yo female with Neck Pain and Neuro Signs and Swelling in her hands

Contributed By:
Linda Simon, DC
Case Presentation: Page 1 of 5

Patient presented with stiffness and swelling of her hands, left worse than right. She also complained of pain in her neck and shoulder bilaterally. She notices this mostly when she wakes up in the morning. There is swelling at the left extensor wrist, palmar surface of the hand and 4th and 5th digits. The right wrist and hand do not exhibit swelling. There was pain and tenderness at the left anterior shoulder, flexor forearm, palmar wrist and hand upon palpation. There was also some pain upon palpation of the right palmar wrist and distal flexor forearm.

 

This patient has a history of a left frozen shoulder from 8 years prior which she never had treated. There is marked reduction of all ranges of motion in her left shoulder. This patient has atrophy in her upper extremities at her shoulders. She is also carrying her head in a flexion posture and rounding both her shoulders anteriorly. She is overweight but does not have a history of diabetes. She has a history of mild osteoarthritis in her neck.

 

Question: What diagnoses would you consider with this patient at this time?

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