Shoulder Pain

Introduction & Question 1

Introduction

A 25-year-old, right-hand-dominant volleyball player complains of right shoulder pain during overhead activities. She recalls falling on an outstretched hand while diving for a ball. Her symptoms began approximately 3 months ago and have been worsening. She does not have pain at rest. Anti-inflammatory medications have not provided relief.

On physical examination, she has full range of motion of her shoulders, full strength of the rotator cuff, and generalized laxity. She has slightly increased anterior and posterior translation in her right shoulder. With her shoulder abducted to 90° and externally rotated in the supine position, she does not feel that her shoulder wants to "come out" (negative apprehension sign). Posterior pressure applied by the examiner on the humerus does not provide relief of apprehension (negative relocation sign).

Question 1

Based on the above presentation, what is the most likely diagnosis?

1. 
   Glenohumeral instability
   
2. 
   Rotator cuff tear
   
3. 
   Adhesive capsulitis
   
4. 
   Superior labral tear
   

On physical examination, she has full range of motion of her shoulders, full strength of the rotator cuff, and generalized laxity. She has slightly increased anterior and posterior translation in her right shoulder. With her shoulder abducted to 90° and externally rotated in the supine position, she does not feel that her shoulder wants to "come out" (negative apprehension sign). Posterior pressure applied by the examiner on the humerus does not provide relief of apprehension (negative relocation sign).