S43.499A Other sprain of unspecified shoulder joint, initial encounter
S46.819A Strain of other muscles, fascia and tendons at shoulder and upper arm level, unspecified arm, initial encounter
PREFERRED PRACTICE PATTERNS
4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Connective Tissue Dysfunction
4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Localized Inflammation
A 23-year-old male college gymnast presents with right shoulder pain and significant ecchymosis that spreads down to the elbow. He reports that he over-rotated during a flip on the parallel bars and he caught himself with his right arm. He felt a sudden sharp pain in his right shoulder and then a cramp-like contraction in his right arm and chest. He later noticed discoloration in his chest and right arm and a depression in the right anterior portion of his chest. He states that he feels a constant pain in his right shoulder along with noticeable weakness.
Pectoralis major, lower portion (C5–8; T1; lateral and medial pectoral nerves). The arm is adducted from a forward position below the horizontal level against resistance. (From Waxman SG: Clinical Neuroanatomy. 26th ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
Pectoralis major, upper portion (C5–8; T1; lateral and medial pectoral nerves). The arm is adducted from an elevated or horizontal and forward position against resistance. (From Waxman SG. Clinical Neuroanatomy. 26th ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
Pectoralis major muscle. (Reproduced with permission from Morton DA, Foreman KB, Albertine KH. The Big Picture: Gross Anatomy. McGraw-Hill, 2011.)
Diagnosis is made by history and clinical examination with MRI for confirmation of location
Occurs from a sudden high force, typically with ...