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• W3178014765 abstract "HISTORY: A 55-year-old female presented with a 3-month history of right upper arm pain. Patient denied any injury to the arm. She reported a pulling sensation associated with a sharp pain along the middle portion of the upper arm. The pain was constant with intermittent radiation toward the elbow. Symptoms worsened with activities involving elbow flexion and shoulder abduction. She denied any swelling, skin discoloration, numbness, or radicular-type pain. She endorsed pain-related weakness. She tried rest and acetaminophen, which provided limited relief. PHYSICAL EXAMINATION: Examination revealed no visible deformity of the neck or right upper extremity. Active range of motion at the shoulder was minimally decreased in flexion and abduction due to pain, but preserved for the neck and the elbow. Reflexes and sensation to light touch were intact. There was pain with resisted elbow flexion, however, strength was 5/5 in the right upper extremity. There was tenderness to palpation over the muscle belly of the biceps brachii and the origin of the brachialis muscle. Provocative maneuvers at the shoulder were positive for Speed’s and Yergason’s tests. DIFFERENTIAL DIAGNOSIS: 1. Biceps muscle strain 2. Biceps tendinopathy 3. Brachialis muscle strain 4. Cervical radiculopathy 5. Fracture 6. Tumor TESTS AND RESULTS: Right shoulder anterior-posterior, lateral, and scapular-Y radiographs: — Normal alignment. No fracture. Right elbow anterior-posterior and lateral radiographs: — No displaced fractures or dislocations. Right upper extremity limited musculoskeletal ultrasonography: — Hyperechoic appearance of the distal brachialis muscle near the musculotendinous junction possibly representing fatty infiltration. Right humerus magnetic resonance imaging without contrast: — Chronic distal brachialis myotendinous injury with fatty infiltration. No acute muscle/myotendinous injury is seen. FINAL WORKING DIAGNOSIS: Chronic right brachialis muscle injury and tendinopathy TREATMENT AND OUTCOMES: 1. Referral to occupational therapy for range of motion exercises with a gradual progression in strengthening. 2. Oral & topical anti-inflammatory medication for pain control. 3. Return to the clinic in 6-8 weeks for re-evaluation. 4. May consider platelet-rich plasma therapy if symptoms fail to improve." @default.
• W3178014765 created "2021-07-19" @default.
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• W3178014765 date "2021-08-01" @default.
• W3178014765 modified "2023-09-25" @default.
• W3178014765 title "Right Arm Pain — Grocery Store Cashier" @default.
• W3178014765 doi "https://doi.org/10.1249/01.mss.0000764192.34293.e8" @default.
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