A 64-year-old is experiencing chronic pain and weakness in his dominant arm and

Question

A 64-year-old is experiencing chronic pain and weakness in his dominant arm and shoulder for the previous 2 months, with no previous trauma. He has minor pain on palpation of the right shoulder. His pain is increased with arm abduction of more than 90° and has weakness with external rotation of the arm. He cannot maintain his arm in an elevated position for more than a few seconds. An injection of local anesthetic relieves his pain but does not help with the weakness.

1. Explain the possible anatomical causes for each of these symptoms and identify the anatomical structures likely to be involved.

2. Identify three differential diagnoses (diseases or conditions that present similar signs and symptoms that could possibly account for the symptoms) with appropriate justifications. Provide the most likely diagnosis based on this analyses.

3. From an anatomy point of view: * Explain the various treatment options for the presenting symptoms. * Propose a management plan for the most likely diagnosis. * Explain the effects of the management plan for this condition.

Explanation / Answer

Answer 1. The symptoms shown in the given question points towards the diagnosis of shoulder bursitis. Bursitis is the swelling and infection of the fluid filled spaces in the joints. Subacromial bursa is most commonly involved in shoulder bursitis.The main causes include infection and rotator cuff injury. The other structures involved in this disease are rotator cuff muscles namely supraspinatus, infraspinatus, teres minor and subscapularis.

Answer 2. The diffencial diagnosis of these symptoms tear in rotator cuff, frozen shoulder, tendinitis, nerve injury, Osteoarthritis. The most common diagnosis seems to be bursitis.

Answer 3. Management for the given sign and symptoms include prevention and treatment. Prevention includes joint protection and physical exercise,ice pack, rest etc. Treatment includes NSAIDS i. e. Non steroidal anti inflammatory drugs like ibuprofen, pain killer etc. Surgical management is required in advanced cases. The main aim of the management is to improve inflammation, relieve pain and fever.

Related Questions

Navigate

• Browse (All)
• Browse A
• Subjects

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.