A 47-year-old man is evaluated for right lateral shoulder pain. He has been pitching during batting practice for his son's baseball team for the past

Subject
Medicine
System
Rheumatology/Orthopedics & Sports

Kathryn

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Jul 29, 2020
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A 47-year-old man is evaluated for right lateral shoulder pain. He has been pitching during batting practice for his son's baseball team for the past 2 months. He has shoulder pain when lifting his right arm overhead and also when lying on the shoulder while sleeping. Acetaminophen does not relieve the pain. On physical examination, he has no shoulder deformities or swelling. Range of motion is normal. He has subacromial tenderness to palpation, with shoulder pain elicited at 60 degrees of passive abduction. He also has pain with resisted mid-arc abduction but no pain with resisted elbow flexion or forearm supination. He is able to lower his right arm smoothly from a fully abducted position, and his arm strength for abduction and external rotation against resistance is normal. Which of the following is the most likely diagnosis?
(A) Adhesive capsulitis
(B) Bicipital tendinitis
(C) Glenohumeral arthritis
(D) Rotator cuff tear (complete)
(E) Rotator cuff tendinitis
 
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