Your patient a 14 year old soccer player fell on the soulder and neck after scorring a goal, when she had her legs swept out from under her by a defensive player. she is unable to move her right arm and in shoulder flexion and abduction, muscles are graded at 2/5 on assessment. The shoulder in internally rotated and her hand is in waiters tip position after a week. The shoulder MRI was normal. What is the clinical diagnosis
Question
Your patient a 14 year old soccer player fell on the soulder and neck after scorring a goal, when she had her legs swept out from under her by a defensive player. she is unable to move her right arm and in shoulder flexion and abduction, muscles are graded at 2/5 on assessment. The shoulder in internally rotated and her hand is in waiters tip position after a week. The shoulder MRI was normal. What is the clinical diagnosis
Solution
The clinical diagnosis for this patient is likely Erb's Palsy, also known as Brachial Plexus Palsy. This condition is usually caused by an injury to the upper nerves of the brachial plexus, a network of nerves near the neck that give rise to all the nerves of the arm. These injuries can occur as a result of shoulder trauma, like in this case. The "waiter's tip" position of the hand is a classic presentation of this condition, as is the weakness in shoulder flexion and abduction. The normal MRI suggests that the injury is likely to the nerves themselves, rather than to the structures of the shoulder.
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