Rotator Cuff Injury Case Study

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Case Study 11: THE PITCHER WITH A SORE ARM 1. Why is Jason given an MRI scan rather than an X ray? Answer: MRI is suited for soft tissue evaluation, e.g. ligament and tendon injury, spinal cord injury, brain tumors etc. However, X-Rays are largely used to examine broken bones. Jason is given an MRI scan rather than an X ray because a muscular disorder is suspected. 2. Why do Jason’s symptoms develop during the season and not during training? Answer: Excessive use of shoulder leads to inflammation and pain in the rotator cuff, the collection of muscles, tendons, and cartilage that stabilize the shoulder joint. As a baseball player, Jason makes a great use of his shoulder and arms to pitch the balls, which may lead to tendonitis,…show more content…
Why does the team physician suspect a rotator cuff injury? How do the results of the physical examination support that diagnosis? Answer: Jason is a baseball player. The team physician suspects a rotator cuff injury, because of the likelihood of this affection in people making a great use of their shoulders, such as athletes, weightlifters, and construction workers. The following results of the physical examination support the diagnosis: • All the muscles are normal except the right arm rotator cuff muscles, which are given a grade of 4- in a manual test. • Right shoulder “droop” and lack of free movement of right arm during walking. • Right shoulder and arm held more closely to body • Abnormal range of motion of the right shoulder, which is reduced and guarded • Inflammation of muscles of the right shoulder. 4. List the muscles of the rotator cuff. Answer: The muscles in the rotator cuff include: Teres minor; Infraspinatus; Supraspinatus;…show more content…
• Atrophied muscle fascicles, a large number of inflammatory cells surrounding the blood vessels. • Histological and histochemical abnormalities • Changes in cell ultrastructure. 8. A patient has drooping upper eyelids and is unable to raise them. Determine the muscles affected and what nerve(s) may be involved. Answer: The muscle is the levator muscle : the major muscle responsible for elevating the upper eyelid. responsible for elevating the upper eyelid. The nerve involved is the oculomotor nerve: the nerve that stimulates the levator muscle. 9. John, a 25-year-old construction worker, is brought to the hospital emergency room with severe damage to his left forearm. The injury occurred when he caught his arm between a wall and some falling steel beams as part of a building collapsed; it took approximately 2 hours to free him. In the emergency room, his arm appears swollen, and laboratory tests reveal elevated concentrations of serum CK, LDH, and aldolase. As John’s condition is monitored, the hospital staff should be alert for: a. the appearance of dark, reddish-brown urine. b. atrophy of the muscles of the left

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