Image Quiz
Persisting Pain and Limitation of Motion Following an Injury to the Shoulder1
A forty-two-year-old, right-hand dominant, athletic man who worked as a carpenter sustained an injury to the left shoulder while playing football. An anteroposterior radiograph of the shoulder was interpreted as normal in an emergency department, and treatment was started with pain medication and application of a sling. A week later, he was reexamined and physiotherapy was initiated. Despite physiotherapy and rest, the patient had pain and limitation of shoulder movement. He was referred to our department three months after the injury.
On clinical examination, the patient had painful restriction of both active and passive glenohumeral movement in all directions. Abduction and forward elevation was 50°, internal rotation was 40°, and there was no external rotation. No neurovascular impairment was found, and the patient reported incapacitating night pain. Imaging studies were obtained (Figs. 1-A, 1-B, and 1-C).
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Fig. 1-A |
Fig. 1-B |
Fig. 1-C |
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