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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?

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