A 45-year-old man enters the outpatient physical therapy department with a compl

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A 45-year-old man enters the outpatient physical therapy department with a complaint of rightshoulder pain of 1 week’s duration. The pain began Monday morning following a weekend of scrapingand painting his house. The patient describes his pain as aching and troublesome; his pain is a 6on a pain scale of 0 to 10. He reports that he is married, and having difficulty in home maintenanceactivities such as lawn mowing. He is able to perform only 30% of his normal home and recreationalactivities. The therapist decides to conduct a musculoskeletal examination.While palpating the shoulder region, increased tenderness and skin temperature in the region ofthe bicipital groove of the right anterior shoulder is noted. Active ROM of the right shoulder revealsincreased pain and some limitations during shoulder flexion, abduction, and extension; all other activemotions are pain free and within normal ROM limits. Passive shoulder motions are pain free withnormal ROM, except for shoulder extension, which is limited and causes an increase in pain towardthe end of motion. QUESTIONS1. What additional information should be gathered during the interview?2. What is a capsular pattern of limitation? Does this patient have a capsular pattern of limitation forthe glenohumeral joint?3. The therapist suspects the presence of bicipital tendinitis. Do the findings during testing of activeand passive ROM support this diagnosis? Explain.4. What additional tests should be performed to selectively examine contractile tissue and help tosupport or repudiate the diagnosis of bicipital tendinitis? Provide a rationale for your selection. A 45-year-old man enters the outpatient physical therapy department with a complaint of rightshoulder pain of 1 week’s duration. The pain began Monday morning following a weekend of scrapingand painting his house. The patient describes his pain as aching and troublesome; his pain is a 6on a pain scale of 0 to 10. He reports that he is married, and having difficulty in home maintenanceactivities such as lawn mowing. He is able to perform only 30% of his normal home and recreationalactivities. The therapist decides to conduct a musculoskeletal examination.While palpating the shoulder region, increased tenderness and skin temperature in the region ofthe bicipital groove of the right anterior shoulder is noted. Active ROM of the right shoulder revealsincreased pain and some limitations during shoulder flexion, abduction, and extension; all other activemotions are pain free and within normal ROM limits. Passive shoulder motions are pain free withnormal ROM, except for shoulder extension, which is limited and causes an increase in pain towardthe end of motion. QUESTIONS1. What additional information should be gathered during the interview?2. What is a capsular pattern of limitation? Does this patient have a capsular pattern of limitation forthe glenohumeral joint?3. The therapist suspects the presence of bicipital tendinitis. Do the findings during testing of activeand passive ROM support this diagnosis? Explain.4. What additional tests should be performed to selectively examine contractile tissue and help tosupport or repudiate the diagnosis of bicipital tendinitis? Provide a rationale for your selection. A 45-year-old man enters the outpatient physical therapy department with a complaint of rightshoulder pain of 1 week’s duration. The pain began Monday morning following a weekend of scrapingand painting his house. The patient describes his pain as aching and troublesome; his pain is a 6on a pain scale of 0 to 10. He reports that he is married, and having difficulty in home maintenanceactivities such as lawn mowing. He is able to perform only 30% of his normal home and recreationalactivities. The therapist decides to conduct a musculoskeletal examination.While palpating the shoulder region, increased tenderness and skin temperature in the region ofthe bicipital groove of the right anterior shoulder is noted. Active ROM of the right shoulder revealsincreased pain and some limitations during shoulder flexion, abduction, and extension; all other activemotions are pain free and within normal ROM limits. Passive shoulder motions are pain free withnormal ROM, except for shoulder extension, which is limited and causes an increase in pain towardthe end of motion. QUESTIONS1. What additional information should be gathered during the interview?2. What is a capsular pattern of limitation? Does this patient have a capsular pattern of limitation forthe glenohumeral joint?3. The therapist suspects the presence of bicipital tendinitis. Do the findings during testing of activeand passive ROM support this diagnosis? Explain.4. What additional tests should be performed to selectively examine contractile tissue and help tosupport or repudiate the diagnosis of bicipital tendinitis? Provide a rationale for your selection.

Explanation / Answer

ANSWER TO QUESTION 1

ADDITIONAL INFORMATION TO BE GATHERED DURING THE INTERVIEW :

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