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Physical Medicine and Rehabilitation (91)
Author(s) -
Petchkrua Wannapha,
Harris Stacy A.
Publication year - 2001
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/j.1533-2500.2001.1011-91.x
Subject(s) - medicine , dermatome , pneumonia , rehabilitation , stroke (engine) , referred pain , physical therapy , surgery , anesthesia , engineering , mechanical engineering
Shoulder pain as an unusual presentation of pneumonia in a stroke patient: a case report. (University of Chicago Hospitals, Chicago, IL) Arch Med Phys Rehabil 2000;81:827–829. An 89‐year‐old woman with right hemiparesis secondary to ischemic lacunar infarction who developed sudden onset of right shoulder pain on the fifth day of inpatient rehabilitation is discussed in this case study. The pain was severe, limiting range of motion (ROM) and participation in therapy. Extensive investigations to rule out subluxation, fracture, connective tissue disease, RSD, and pulmonary embolism were negative. Ultimately, her shoulder pain and decreased ROM completely resolved with antibiotic treatment for right lower lobe pneumonia. Conclude that her symptoms were possibly referred pain from diaphragmatic irritation transmitted via right C4 sensory axons in the phrenic nerve, which shares the same dermatome as the right acromion area. This case was an unusual presentation of pneumonia in an elderly woman with hemiplegia. The authors recommend that pneumonia be considered in differential diagnoses of shoulder pain.