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A 26-Year-Old Woman With Shoulder Pain
Stephen S. Burkhart, MD, Discussant
JAMA. 2000;284:1559-1567.
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INTRODUCTION
DR PARKER: Mrs B is a 26-year-old teacher whose activities are severely limited by chronic left shoulder pain. She has been treated with nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and cortisone injections without adequate improvement. Mrs B lives in a suburb of Boston and has managed care insurance.
During adolescence, Mrs B experienced back pain and was diagnosed as having kyphosis and lordosis, for which she wore a brace. Despite this, she remained active in sports. Four years ago, pain began in both shoulders without any preceding trauma or other joint symptoms. Her internist, and subsequently several orthopedists, evaluated her. The initial diagnoses included subdeltoid bursitis, rotator cuff tendonitis, and impingement.
Mrs B notes that shoulder pain interrupts her sleep every night. She cannot brush her hair, brush her teeth, or lift her arms without pain. She enjoys swimming but cannot swim the crawl or . . . [Full Text of this Article]
MRS B: HER VIEWS
DR K: HER VIEWS
AT THE CROSSROADS: QUESTIONS FOR DR BURKHART
The Spectrum of Shoulder Disease Clinical Presentation Diagnostic Studies Pathoanatomy Nonoperative Treatment Options Arthroscopic Treatment Arthroplasty Recommendations for Mrs B
QUESTIONS AND DISCUSSION
Author Affiliation: Dr Burkhart is Clinical Associate Professor, Baylor College of Medicine and the University of Texas Health Science Center, San Antonio.
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