Reverse Shoulder Arthroplasty Pathway Posted: 4/13/2021 ID: (C101748) Shoulder360™ The Comprehensive Shoulder Course

Acromial Stress Fracture Following Reverse TSA in 69F

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CASE DESCRIPTION

AGE	69 / Female
CC	L shoulder pain
HPI	A 69-year-old female presents for evaluation of left shoulder pain. The patient has undergone a prior left TSA in 2016 and had done well for 3 years prior to requiring conversion to a reverse TSA. Postoperatively from the rTSA she did well for 2 months before presenting to the clinic with a complaint of severe pain after feeling a pop on the top of the shoulder. She denies any direct trauma or falls, no numbness or tingling in the arm or hand.
PMH	Medical history: Chronic kidney disease, hypertension, thoracic outlet syndrome Surgical history: L TSA, L conversion to reverse TSA (2019), R reverse TSA, bilateral TKA, thoracic outlet surgery
PE	Focused physical exam of the left upper extremity shows well healed surgical incision over the anterior shoulder. Focal tenderness over the lateral acromion. There is pain with abduction of the shoulder. Sensation and motor are intact distally with 2+ pulses in the hand.

AGE/GENDER:

69 / Female

CHIEF COMPLAINT:

L shoulder pain

HISTORY OF PRESENT ILLNESS:

A 69-year-old female presents for evaluation of left shoulder pain. The patient has undergone a prior left TSA in 2016 and had done well for 3 years prior to requiring conversion to a reverse TSA. Postoperatively from the rTSA she did well for 2 months before presenting to the clinic with a complaint of severe pain after feeling a pop on the top of the shoulder. She denies any direct trauma or falls, no numbness or tingling in the arm or hand.

PAST MEDICAL HISTORY:	Medical history: Chronic kidney disease, hypertension, thoracic outlet syndrome Surgical history: L TSA, L conversion to reverse TSA (2019), R reverse TSA, bilateral TKA, thoracic outlet surgery
PHYSICAL EXAM:	Focused physical exam of the left upper extremity shows well healed surgical incision over the anterior shoulder. Focal tenderness over the lateral acromion. There is pain with abduction of the shoulder. Sensation and motor are intact distally with 2+ pulses in the hand.
DIAGNOSIS:	Acromial Stress Fracture Following Reverse TSA in 69F