A 65-year-old white female sustains a fall forward, with outstretched

Case Study

A 65-year-old white female sustains a fall forward, with outstretched left arm bracing her fall, and lands on her left shoulder. She is out of the country when the injury occurs. She uses a scarf as a sling for support. On return home she sees her PCP. She has limited ROM to abduction, adduction, internal, and external rotation. An x-ray is ordered and demonstrates no fractures. She is placed in a shoulder mobilizer and given an anti-inflammatory. She regains her mobility with some continued soreness. Three months later, the patient develops severe pain in her left shoulder. She cannot turn over in the bed due to pain. She cannot raise her arm over her head, and the limited ROM has returned.

• What would be your diagnosis and treatment plan?
• Please list three differential diagnoses.
• Make sure you rule in or rule out the differentials.