BOF: 2.21
A 28-year-old male presents with pain and weakness of his
right shoulder. He gives a history of a recent upper respiratory tract
infection. On examination there is wasting and weakness of his supraspinatus
and infraspinatus muscles and passive movements of the shoulder are painful.
The likely diagnosis is:
a)
Polymyositis
b)
Neuralgic amyotrophy
c)
Proximal spinal muscular atrophy
d)
Erb’s palsy
e)
Thoracic outlet syndrome
Answer:
b)
The clinical features described
are very much in favour of neuralgic amyotrophy
. Proximal spinal muscular atrophy causes slowly progressive usually
symmetrical wasting and weakness. Erb’s palsy affects nerve roots C5,
C6 and thoracic outlet syndrome affects C8 and T1.
Polymyositis usually affects people in their 4th and 5th
decades of life and causes proximal weakness with aching muscles, which are
sometimes tender and indurated.
Neuralgic amyotrophy
