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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

Abstract

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 levels.

Question 4 4. How would you manage this patient?

Answers can be found on page 2.

  • bone disease
  • endocrinology
  • general paediatrics
  • bone metabolism

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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.

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