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Clinical Crossroads Update
June 27, 2001

A 26-Year-Old Woman With Shoulder Pain, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2001;285(24):3140. doi:10.1001/jama.285.24.3140

In March 2000, Stephen S. Burkhart, MD, discussed a 26-year-old woman with severe chronic shoulder pain. Mrs B was a physical education teacher whose activities were limited by chronic left shoulder pain. She had tried physical therapy, nonsteroidal anti-inflammatory drugs, and cortisone injections without adequate relief. The pain started 4 years earlier in both shoulders without preceding injury, and diagnoses included subdeltoid bursitis, rotator cuff tendonitis, and impingement. The pain awakened her from sleep and interfered with basic activities such as brushing her hair and lifting her arm. A magnetic resonance image (MRI) showed a possible small tear in the rotator cuff. She wondered whether surgery would afford long-term relief and how difficult the recovery period would be.

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