A 57-Year-Old Man With Vague Left Shoulder Pain

Emmanuel K. Konstantakos, MD; Lynn A. Crosby, MD

Disclosures

April 27, 2016

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case you would like to suggest for a future Case Challenge, please contact us.

Background

A 57-year-old man presents to the emergency department with vague left shoulder pain for the past 3 months after an incident in which a garage door fell on him. The pain is slightly worse with movement, but he denies any limitation in the range of motion. The pain is dull and has recently become increasingly severe. He denies experiencing any prior trauma to the area, as well as any history of arthralgia, myalgia, other associated symptoms, or any prior surgeries or medical problems. He denies weight loss, chills, night sweats, or recent illnesses.

The patient smoked about one pack of cigarettes per day for about 30 years, but he quit 8 years ago. He drinks one or two beers every night. He does not use any illicit drugs and does not take any medications other than an occasional nonsteroidal anti-inflammatory drug, which seems to relieve the pain. He has no allergies.

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