#january2020mccqe1
A 59-year-old woman is evaluated for a 3-week history of pain in the right upper scapula and trapezius areas. There are no paresthesias. On physical examination, the shoulder has full range of motion without eliciting worse pain or altering the character of the pain. There is no sign of rotator cuff pain or weakness with testing against resistance. There are no signs of impingement. The shoulder apprehension test is negative. Strength, deep tendon reflexes, and sensation are normal bilaterally. What is the most appropriate next step in this patient's management?
(A) Chest radiograph
(B) Intra-articular corticosteroid injection
(C) Physical therapy
(D) Radiograph of the shoulder
(E) Skeletal muscle relaxant
A 59-year-old woman is evaluated for a 3-week history of pain in the right upper scapula and trapezius areas. There are no paresthesias. On physical examination, the shoulder has full range of motion without eliciting worse pain or altering the character of the pain. There is no sign of rotator cuff pain or weakness with testing against resistance. There are no signs of impingement. The shoulder apprehension test is negative. Strength, deep tendon reflexes, and sensation are normal bilaterally. What is the most appropriate next step in this patient's management?
(A) Chest radiograph
(B) Intra-articular corticosteroid injection
(C) Physical therapy
(D) Radiograph of the shoulder
(E) Skeletal muscle relaxant
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