Step 2

Orthopedics 3

A 45-year-old woman comes to the physician because of a 10-week history of right shoulder pain that worsens with reaching overhead. The pain often disturbs her sleep, especially when lying on the affected side. She has no history of trauma or significant medical conditions and is not on any medication. On physical examination, there is no visible muscle atrophy. There is tenderness on palpation immediately below the acromion. Active abduction of the right shoulder is limited to 110 degrees without resistance and with resistance is limited due to pain. Neurological examination reveals no weakness or other deficits, and peripheral pulses are normal. X-rays of the right shoulder show no abnormalities.

Which of the following is the most likely diagnosis?

  • A) Accessory nerve palsy
  • B) Acromioclavicular separation
  • C) Occult fracture of the proximal humerus
  • D) Rotator cuff tendinopathy
  • E) Suprascapular nerve palsy


Lloyd Taylor


Dr. Ted O'Connell

Last updated

Jun 09, 2024

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