Case of the Month 0ctober 1998

This 29 year old woman presented to the local emergency room with complaints of pain and swelling in her left upper extremity.  On physical examination she had significantly limited range of motion in her shoulder and a mildly erythematous and swollen region overlying her left clavicle.  She noted that the pain had only been present for several weeks, but had acutely gotten worse earlier in the day.  On review of systems, she noted a mild sore throat and URI several weeks previously, but otherwise denied systemic complaints.  On laboratory analysis her WBC was 11,000 and her ESR was 21.  Other lab values were normal. A plain radiograph and an MRI were obtained.

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