why this blog?

Likelihood Ratio (LR) in Emergency Medicine

2/09/2014

Does every shoulder pain means magnetic risonance?


Clinical Scenario

A 35 y/o male come to the ED because of pain in his right shoulder, he refers the pain started some month ago during a tennis match, the pain continued but it wasn't so high so he kept playing in the last months, now it is worse. "My tennis mate told me I should perform a magnetic resonance, because it might be a rotator cuff disease" (RCD).
You listen to the patient but decide first to act as a physician and make the old and fascinating physical examination...
What you find is a normal movement of the shoulder, no pain in abducting the arm (arch test), no weakness or pain in internal and external rotation. (see video)


And so what?






Conclusion 

Shoulder pain is the third most common musculoskeletal reason for seeking medical care, affecting between 7% and 26% of adults at any time.
The prevalence of rotatory cuff disease in a population of less than 70 y/o is 2,8 to 15%. Has our patient is a tennis player we can assume he has a pretest probability of about 10%, so in this case the post test probability drop to 0,4%...we may skip magnetic resonance for this time.




Bibliography 

8 comments:

  1. very interesting post! i liked it very much! thanks for sharing your thoughts and for your efforts!

    Goljan Rapid Review Pathology

    ReplyDelete
  2. Great post! & you have informative site. Thanks for your informative health blog (shoulder pain). We have a informative site, We get provided any advising for health labyrinth. To get more information Please visit shoulder pain Thanks

    ReplyDelete
  3. No! Painful shoulder conditions that limit movement are common, and are caused by problems with the shoulder joint and its surrounding structures. The shoulder is more prone to injuries than other joints because of its wide range of movement. Common conditions that can result in chronic shoulder pain include rotator cuff disorders, adhesive capsulitis, shoulder instability, and shoulder arthritis. Rotator cuff disorders include tendinopathy, partial tears, and complete tears. Here Shoulder Pain Treatment In Beverly Hills is been done by the leading hemiarthroplasty surgeon Dr. Sonu Ahluwalia. Know more about torn rotator cuff and Shoulder Pain Treatment for quick recovery. Take care. Thanks.

    ReplyDelete
  4. Great post, you have pointed out some superb details, I will tell my friends that this is a very informative blog thanks


    Usmle Medical Books Store

    ReplyDelete
  5. "Don't walk behind me; I may not lead. Don't walk in front of me; I may not follow. Just walk beside me and be my friend.
    - quotes about love
    - snake game
    - chinese food near me
    - panama papers
    - Fancam
    "

    ReplyDelete