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• W2043993782 abstract "HISTORY 23 year old woman - elite skier - dancing the waltz - collision with another pair - little pain in her left shoulder. Pain was increasing - also pain in the left thoracic side - in the morning phoned medical doctor - clinic. PHYSICAL EXAMINATION ROM of the left shoulder limited in all planes. Abduction 30°, outside rotation 5°, inside rotation 10°, anteversion 40°, retroversion 10°. Passive moving of the shoulder was painful, active moving very painful. No warmingsigns, no effusion, no swelling. No neurological signs. No signs of in.ammation. Breathing was painful, she was short of breath and she felt weak. Digital and manual examination of the spine and the ribs: no pathological signs; manual compression of the thorax: little pain. Physical examination by stethoscope and percussion of the lungs: no pathological signs. No pathogenic neurological signs. Abdominal muscles: higher tension, epigastric space and left side of abdomen: painful. DIFFERENTIAL DIAGNOSIS Frozen Shoulder Thoracic contusion Pneumothorax Pleuritis Pulmonal In.ammation Splenic Rupture TEST AND RESULTS Thorax radiographs, no findings Laboratory no findings Ultrasonic of thoracic space: No pathological signs Ultrasonic of abdomen: Free fluid in abdominal cave MRI shows free fluid in abdominal cave, left hemidiaphragma was higher and lower part of left lung shows more density FINAL WORKING DIAGNOSIS Subcapsular hematoma of the splen, followed later bei Rupture of the spleen (retarded rupture) Special investigastion of the Anamnesis: Three weeks before the dancing event the athlete took part in the alpine ski world cup final in Super G. In this race she had a collision with a gate-pole on the left side of her trunk - she finished the race in the fifth place. After that she went to the Team-doctor and she was examined, because she had pain on the left side of her trunk. Diagnosis: Contusion of the trunk. Therapy: NSARDs. After three days she was pain free and was able to go back to her normal training programme. TREATMENT AND OUTCOMES Endoscopic surgery of the abdominal cave, drainage of the hematoma and the free fluid. ing the rupture with fibrin and covering the spleen with vikrylnet Bed rest for 5 days - breath-gymnastics 6th day ps mobilisation (walking) end of the third week walking with poles fifth week stabilisation training of the trunk eigth week after surgery strength training on machines and sensomotoric training Ten weeks after surgery running Twelve weeks ps comeback to the usual training-process 16 weeks after surgery back in competition Ten months after the injury winner of the gold medal of the world championship in Super G" @default.
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• W2043993782 date "2005-05-01" @default.
• W2043993782 modified "2023-09-25" @default.
• W2043993782 title "Acute Left Shoulder Pain - An Extraordinary Pitfall" @default.
• W2043993782 doi "https://doi.org/10.1097/00005768-200505001-02125" @default.
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