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 Answer BOF 2.21

 

   

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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

 

Revision Tip

 

Revise neuralgic amyotrophy KEYS to SUCCESS in Medicine page 477-478

 

 

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