4 board-style questions on shoulder pain in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.
A 50-year-old woman presents with right shoulder pain that has worsened over the past month. The pain is worse when reaching overhead or behind her back. She denies trauma, neck pain, or numbness in her arm. On examination, she has a painful arc of motion between 60 and 120 degrees of abduction. The Neer test (passive forward flexion with scapular stabilization) and Hawkins-Kennedy test (forward flexion to 90 degrees with internal rotation) are both positive. Strength testing of the rotator cuff muscles is intact. What is the most likely diagnosis?
A 53-year-old woman with type 2 diabetes presents with progressive right shoulder stiffness over the past 4 months. She reports difficulty reaching behind her back to fasten her bra and cannot raise her arm to wash her hair. She denies trauma. On examination, both active AND passive range of motion are significantly restricted: external rotation is 15 degrees (normal 60-90 degrees), forward flexion is 100 degrees (normal 180 degrees), and internal rotation is limited to the buttock level. Shoulder X-ray is normal. What is the most likely diagnosis, and what is the most appropriate initial management?
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