Can't Shrug This Shoulder Pain -- Not Your Typical Overuse Injury

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Can't Shrug This Shoulder Pain -- Not Your Typical Overuse Injury - Page #3

Lab Studies: Complete blood count and comprehensive metabolic panel were within normal limits. Magnesium was normal. PT/INR/PTT were normal. Troponin level was 3 and BNP was 8. Other Studies: Radiographs of the right shoulder were unremarkable. <br>MR arthrogram of the right shoulder showed an anterior superior labral defect at 11:00-3:00 which was suspicious for a possible superior glenoid labral tear. No rotator cuff tear. <br>Doppler Ultrasound of the right upper extremity showed an occlusive deep vein thrombosis from the right subclavian vein to the distal right brachial vein. <br>Peri-operative right upper extremity venogram demonstrated a complete occlusion of the right brachial, axillary, & subclavian veins. Large collateral from brachial to basilic vein, which appeared to drain the majority of the right upper extremity. Patent superior vena cava & right internal jugular. <br>BRACHIAL AND AXILLARY VEINS <br>Pre-Angio: NOTE COLLATERAL FLOW VIA PERFORATING VEINS FROM DEEP (BRACHIAL, AXILLARY, SUBCLAVIAN) TO SUPERFICIAL SYSTEM (IJ) <br> <a href="CaseStudyImages/CS3CS2CS1Can039tShru-1296.jpg" title="Case Photo #3" data-lity><b>Case Photo #3</b></a> <br>Post-Angio <br> <a href="CaseStudyImages/CS4CS3CS2CS1Can039tS-1296.jpg" title="Case Photo #4" data-lity><b>Case Photo #4</b></a> <br>Pre-Angio Subclavian <br> <a href="CaseStudyImages/CS5CS4CS3CS2CS1Can03-1296.jpg" title="Case Photo #5" data-lity><b>Case Photo #5</b></a> <br>Post-Angio Subclavian 1 <br> <a href="CaseStudyImages/CS6CS5CS4CS3CS2CS1Ca-1296.jpg" title="Case Photo #6" data-lity><b>Case Photo #6</b></a> <br>Post-Angio Subclavian 2 <br> <a href="CaseStudyImages/CS7CS6CS5CS4CS3CS2CS-1296.jpg" title="Case Photo #7" data-lity><b>Case Photo #7</b></a> Consultations: Orthopedic surgery <br>Vascular surgery <br>Cardiothoracic surgery Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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