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Right shoulder pain in an athletic 14-year-old girl
  1. Jia Xuan Siew1,
  2. Fabian Yap2
  1. 1 Pediatric Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
  2. 2 Pediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore, Singapore
  1. Correspondence to Dr Jia Xuan Siew, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore SG 229899, Singapore; siew.jia.xuan{at}singhealth.com.sg

https://doi.org/10.1136/archdischild-2018-315774

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    A 14-year-old athletic girl with a history of intermittent aches and pains following sports presented with right shoulder pain after a fall during basketball. On examination, tenderness over the anterolateral deltoid to the mid-humeral shaft was noted, extremes of shoulder movement were limited, but no deformity was present. No other injuries were present. A right shoulder X-ray was requested (figure 1).

    Figure 1

    Right shoulder X-ray.

    Questions 1

    1. What abnormalities are visible on the shoulder X-ray?

    Question 2

    2. What is the most likely diagnosis?

    1. Fracture of the surgical neck of the humerus.

    2. Subluxation of the shoulder.

    3. Malignancy.

    4. Hyperparathyroidism.

    5. Scoliosis.

    6. Severe vitamin D deficiency.

    Question 3

    3. What investigation is most likely to reveal the underlying diagnosis?

    1. Y-scapula view of the right shoulder.

    2. Serum bone profile.

    3. Radioisotope bone scan.

    4. MRI of the right shoulder.

    5. Skeletal survey, including full spine X-ray.

    6. Serum 25-hydroxyvitamin D …

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    Footnotes

    • Contributors JXS prepared the manuscript. FY critically reviewed and edited the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.