Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic right shoulder pain, localized to the lateral deltoid, exacerbated by overhead activities and nocturnal discomfort. Reports significant weakness in abduction and external rotation, with a history of progressive functional decline and inability to perform activities of daily living. No history of acute trauma, or acute traumatic event noted.
Clinical Examination Findings
Physical examination of the right shoulder reveals atrophy of the supraspinatus and infraspinatus fossae. Active range of motion is limited in abduction and external rotation. Positive drop-arm test, positive Jobe’s test (empty can), and positive external rotation lag sign. Passive range of motion remains preserved. Neurovascular status is intact distally.
Treatment Protocol
Recommended treatment plan includes a trial of physical therapy focusing on periscapular stabilization and rotator cuff strengthening. Consider subacromial corticosteroid injection for symptomatic relief. If conservative management fails, surgical consultation for arthroscopic rotator cuff repair is indicated. Activity modification and NSAIDs as needed.