Let’s have some fun today:)
In Podcast Episode 26 called: LISTEN! Let’s test your LISTENING and EVALUATION skills, I will see how sharp your listening skills are.
- Start by asking questions that rule out complications.
- Don’t ask too many open ended questions.
- Be diligent at “teasing” out certain diagnoses.
Today’s patient presentation:
- 14 y/o male with c/o left shoulder weakness
- Reports having “possibly” dislocated shoulder at age 11.
- X-rays were negative. No follow up until 3 years later
- PE teacher noticed awkward left shoulder mov’t with weight training in PE class. Esp. bench press and military press.
- c/o difficulty controlling basketball with left handed dribbling
- PE teacher refer student to school AT. AT notices a definite “Clunk” in the “pitcher’s position”
- Pt. denies any significant pain and denies paresthesias.
- No atrophy
- AROM slightly less controlled into flexion and abduction. Difficulty with active IR. (90% of NL flex and ABD)
- PROM-WNL without pain
- Scapular motion-WNL
- Neuro exam- DTR’s, sensation, distal MMT is WNL’s.
- MMT of the shoulder: Flex. 4-4+/5 , ABD. 4/5, ER 4+/5, IR 3/5 (painless weakness)
- C-spine compression test: NEG
- Spurling’s test: NEG
- Liftoff test: POS
- Bear hug and Belly Press tests: POS
- O’Brien test: POS
- Horizontal ADD test: NEG
- Clunk test: POS
- Apprehension sign: NEG
- Relocation test: NEG
- Empty can test: NEG
- Posterior apprehension sign: NEG
Do you know what the answer is? Do you have more questions to ask? Go HERE to leave an answer or ask a question.
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