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Case of the Week: 71M Shoulder Pain & Limited Mobility

case of the week glenohumeral joint glenohumeral joint osteoarthritis osteoarthritis shoulder arthritis shoulder pain
Radiograph Glenohumeral Joint Osteoarthritis

Age/Sex: 71 y/o Male

CC:  Severe right shoulder pain 

HPI: 71 y/o, RHD, male presents with severe right shoulder pain. The patient stated that this is a chronic problem that has progressively worsened over time. There has never been a traumatic incident. They state their pain is ‘deep inside’ and worse at nighttime. They rate their resting pain to be 7/10 and they are functioning at 40%. This patient complains of sleep disturbances. They have not had any therapy, oral antiinflammatories or injections for the shoulder. No previous shoulder surgical history.

PMH: Past medical history includes hypertension, dyslipidemia and GERD. He had a myocardial infarction 5 years ago. Medications taken daily include Clopidogrel (Plavix), Perindopril (Coversyl), Rosuvastatin (Crestor), Esomeprazole (Nexium).

PE: Active ROM for flexion and abduction was 110 degrees, external rotation was 15 degrees and internal rotation was to the SI joint. Passive range of motion demonstrated stiffness and crepitus with abduction to be 50 degrees and external rotation was 10 degrees. Circumduction was painful. There was joint line tenderness of the glenohumeral joint both posteriorly and anteriorly. Cuff testing was rated 5/5. Impingement tests were negative. Speeds and Yergenson’s was negative.

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