The Case Of Traveling Rings And Nighttime Shoulder Pain - Page #3
 

Lab Studies:
Notable labs: Ferritin 34, Vitamin D 25, Free T3 index low at 76.4. <br>Normal studies: CMP, CBC, Magnesium, Phosphorous, ESR/CRP, DHEAS, LH, FSH, prolactin, TSH, estradiol, testosterone.

Other Studies:
X-ray right shoulder (6/2019): Normal alignment with no acute fracture. No degenerative changes. <a href="CaseStudyImages/CS1TheCaseofTravelin-860.jpg" title="Case Photo #1" data-lity><b>Case Photo #1</b></a> <a href="CaseStudyImages/CS2CS1TheCaseofTrave-860.jpg" title="Case Photo #2" data-lity><b>Case Photo #2</b></a> <a href="CaseStudyImages/CS3CS2CS1TheCaseofTr-860.jpg" title="Case Photo #3" data-lity><b>Case Photo #3</b></a> <br> <br>MRI right shoulder (4/2020): Focal bone marrow edema along the proximal humerus measuring 3.3 cm without acute fracture consistent with high-grade bone stress injury. Tendinopathy of the supraspinatus, subscapularis and long head of the biceps. <a href="CaseStudyImages/CS4CS3CS2CS1TheCaseo-860.jpg" title="Case Photo #4" data-lity><b>Case Photo #4</b></a> <a href="CaseStudyImages/CS5CS4CS3CS2CS1TheCa-860.jpg" title="Case Photo #5" data-lity><b>Case Photo #5</b></a> <br> <br>MRI right shoulder (8/2020): Unchanged bone marrow edema at the humeral diaphysis with periosteal reaction. Linear signal at the anteromedial cortex consistent with fracture or osteoid osteoma. <a href="CaseStudyImages/CS6CS5CS4CS3CS2CS1Th-860.jpg" title="Case Photo #6" data-lity><b>Case Photo #6</b></a> <br> <br>CT right shoulder (9/2020): <br>4mm lucency of the superficial cortex of the anterolateral medial proximal humeral shaft with endosteal sclerosis and a small calcified nidus consistent with an osteoid osteoma. There is minimal periostitis and a lucency extending from the shaft into the lesion that is likely a vascular channel. <a href="CaseStudyImages/CS7CS6CS5CS4CS3CS2CS-860.jpg" title="Case Photo #7" data-lity><b>Case Photo #7</b></a>

Consultations:
The case was discussed with the musculoskeletal radiologists.

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