主题：伤科物理治疗组
Hereisthecase:
An18-year-oldrightdominantmalepresentstoanoutpatientphysicaltherapyclinicwithaphysicaltherapyprescriptionfromanorthopedicphysiciantoevaluateandtreatrightshouldersubacromialimpingement.Thepatientstatesthathestartedtoexperienceshoulderpainapproximatelyfourweeksago.Heattributesthecausetoplayingtennisthreetimesduringthepastweekafternotplayingatalloverthewinter.Hisrightshoulderpainincreaseswithreachingforward,reachingbehindhisback,liftinganytypeofweightwithhisrightarmandplayingtennis.Healsoreportsnotbeingabletoreachbehindhisbacktoloophisbeltortuckhisshirtin,activitieshecouldpreviouslydowithoutdifficulty.Theonlypositionthatreliveshisshoulderpainiskeepinghisarmathisside.Hisphysicianstartedhimonacourseofnonsteroidalanti-inflammatorydrugs,whichhashelpeddecreasethepainintensity.X-raysoftheacromioclavicularandglenohumeraljointswerenegativeforanybonyabnormalitiesorstructuraldeficits.Thepatient’smedicalhistoryisotherwiseunremarkable.
Basedontheevaluationandtreatment,thiscaseisconcernedwith4vitalquestions:
1.Basedonthepatient’sdiagnosis,whatdoyouanticipatemaybethecontributingfactorstohiscondition?
2.Whatexaminationsignsmaybeassociatedwithhisdiagnosis?
3.Whatarethemostappropriatephysicaltherapyinterventions?
4.Whatpossible
