Question

Mrs. Johnson is a 73 y.o. female who presents to your office with right shoulder pain. Her and her husband just moved to the area a few months ago, and you have only seen her once for a sinus infection. Today she states that she is having increasing right shoulder pain over the past couple of weeks. She explains that her shoulders have “always bothered” her because she worked in a factory moving boxes for years. She states that she uses naproxen, “prescription strength” and that usually does the trick when her arthritis flares up, but she is out and would like a refill. On exam you note that her right shoulder is tender to palpate, and she has limited motion. She smells of BenGay but otherwise she seems healthy. The area is edematous and when asked she does agree that her arm seems swollen. She denies any falls but remembers that she lost her balance and fell backwards into her recliner a few days ago “kind of hard” but she caught herself when she grabbed for the coffee table. Otherwise she does not recall any injuries. You decide to send Mrs. Johnson for an x-ray and she is in the waiting room until you get the results back. The following radiograph is what is sent to you via teleradiology. WHAT ELSE WOULD YOU LIKE TO ASK MR H=JOHNSON ABOUT HOW SHE HAD BEEN INJURED

Answer 1

Mr Johnson could be asked the following question to assess how she got injured

• Assess  the vision level of the patient because low vision acquity can be a problem and risk to fall
• Was she alome when she had a fall ,how she managed the pain or any discomfort after the incident
• Since when she is taking medication for arthritis
• The type of physical work she does in workplace and home which can give a clear idea of injury occurred
• Any other medical conditions, musculoskeletal problems can led to injury