Approach to shoulder pain Quiz: Ace Your Exams
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A 36-year-old woman presents to the primary care physician for evaluation of right shoulder, neck, and arm pain for the past several weeks. The patient reports associated weakness in her right arm, particularly with overhead movements. The patient describes the pain as “burning” and says it shoots down her right arm. She does not recall any history of injury or trauma. The patient has a history of obesity and hypertension for which she takes amlodipine. Vital signs are within normal limits. Physical examination of the right shoulder shows no evidence of ecchymosis, swelling, erythema, or deformity. The patient has diminished range of motion at the shoulder secondary to pain. Sensation is mildly diminished over the lateral shoulder with noted weakness with shoulder abduction. The patient experiences the pain when the examiner extends and rotates the neck to the right and presses downward on the head. Which of the following is the best next step for diagnosing the underlying cause of shoulder pain in this patient?
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