A fall with anterior shoulder fracture-dislocation that was reduced in the emergency department. A sling was placed and its removal was recommended after 3 weeks. On removal of the immobilization, an area of dysesthesia circumscribed to the lateral region of the shoulder was observed. The patient can perform abduction, but only reaches 15 degrees. She has a magnetic resonance imaging study in which the rotator cuff is undamaged. What is the most likely diagnosis of suspicion?
Dysesthesia of the lateral aspect of the deltoid region of the shoulder (area innervated by the axillary nerve) and paralysis of the deltoid (primary muscle for abduction beyond 15°). The rotator cuff is undamaged in the MRI, ruling out option 1 (it would show us tendinopathy of the teres major). Adhesive capsulitis presents with pain and stiffness of the shoulder, especially on active and passive external rotation. The suprascapular nerve innervates the supraspinatus muscle, which contributes to the first 15º of shoulder abduction (preserved in the statement) and does not innervate the skin of the reflected area.
Tendinopathy of the teres major.
Adhesive capsulitis.
Suprascapular nerve neuropathy.
Axillary nerve injury.
The rotator cuff is undamaged in the MRI, ruling out option 1 (it would show us tendinopathy of the teres major).
Adhesive capsulitis presents with pain and stiffness of the shoulder, especially on active and passive external rotation.
The suprascapular nerve innervates the supraspinatus muscle, which contributes to the first 15º of shoulder abduction (preserved in the statement) and does not innervate the skin of the reflected area.
Dysesthesia of the lateral aspect of the deltoid region of the shoulder (area innervated by the axillary nerve) and paralysis of the deltoid (primary muscle for abduction beyond 15°).