Shoulder Pain 

1. DOOEEEE!!!!!! Shoulder Pain 

2. 2 day old infant of diabetic mom with asymmetric Moro reflex during Dubowitz exam.

3. Clavicle fracture • Most common pediatric fracture (most occuring before age 7) • Fall onto outstretched hand, direct impact, shoulder dystocia • Children heal quickly (adults…not always) • PE : pain, swelling, crepitus, asymmetric Moro (in neonates) • Check distal pulses, focal neuro exam, and lungs (for pneumothorax)

4. 19 yo Polo player hurts his shoulder when he falls off his horse

6. Acromioclavicular (AC) separation • Usually from falls onto shoulder but sometimes from fall onto outstretched arm • Seen in football, rugby, • PE: may see AC joint widened (can use 10lb weight to widen gap) • Patient often holds arm close to chest (to decrease rotation/elevation)

10. 24 yo baseball player develops shoulder pain after pitching 9 innings(….shocker)

18. SLAP injury

19. SLAP injury • (Superior labrum anterior posterior) • Etiology: • Traction injury – overhead pitching (sudden ctx of biceps) • Compression injury – falling and then catching yourself ( humeral head compresses labrum) • Pt. may sometimes complain of clicking sensation in shoulder

20. 53 yo with progressively worsening shoulder pain for 2 years and limited range of motion

21. Rotator Cuff injuries

24. Rotator cuff injuries • Usually from chronic overuse • SITS (supraspinatus, _________, _____ _____, __________) • Any of these can become weakened and tear but most common is the __________ • Rare below age of 40 • Related to chronic impingement of tendons in 95% of cases