Anatomy clinical correlates Quiz: Ace Your Exams

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A 52-year-old woman presents to her primary care physician with worsening right shoulder pain. The patient has difficulty pulling items off the shelf and can no longer do overhead weight exercises. Additionally, the pain often wakes the patient from sleep at night, especially when she lies on the right shoulder. Past medical history is notable for hypertension. On physical examination, the shoulder and elbow are placed at 90 degrees of flexion in front of the body. The patient experiences pain when the examiner internally rotates the shoulder. The left shoulder has a full range of motion. There is no reproducible tenderness on palpation or flexion of the cervical spine. A radiograph of the right shoulder is shown below:  


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Which of the following is the most likely diagnosis?  

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