Rare Shoulder Injury In A Professional Rugby Player

作者：Irvin Sulapas, Meghan McKay, Rehal A. Bhojani · 发表于：Medicine & Science in Sports & Exercise · 年份：2023 · DOI：10.1249/01.mss.0000982972.47203.77 · 研究领域：Shoulder and Clavicle Injuries、Nerve Injury and Rehabilitation、Shoulder Injury and Treatment

HISTORY:A 25 year old male professional rugby player suffered an injury to his right shoulder during a match. He was going for a tackle, then immediately felt numbness on his shoulder and inability to abduct and extend his arm. He described the pain as a 7/10 in the pain scale. He was evaluated on the pitch and was originally diagnosed with a brachial plexus injury and was taken out of the match. He was seen in clinic 2 days later with severe weakness of the right shoulder and no improvement in strength. He denies any radiating pain to the hand, but felt like his shoulder and deltoid region felt weak. PHYSICAL EXAMINATION: Right shoulder: Examination on the pitch had pain on abduction and extension of arm, with a sharp shooting pain down the arm. On repeat examination in the clinic 2 days later, noted 4/5 strength on flexion and abduction, and abduction to around 90 degrees. Decreased sensation around the deltoid muscle area. Normal grip strength. Full range on forward flexion, extension, as well as internal and external rotation DIFFERENTIAL DIAGNOSIS: Brachial plexus injury, C5 neuropraxia, rotator cuff injury. TEST AND RESULTS: Initial x-rays of the cervical spine and right shoulder were normal. EMG study shows severe right axillary mononeuropathy with some abnormal spontaneous activity in all 3 heads of the deltoid, and no motor units were recruited. MRI Cervical spine was normal. MRI Brachial Plexus shows an abnormal appearance of the posterior cord, continuing to radial...