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Bad Shoulder Pain? Get AI Doctor Help for Fast and Accurate Diagnosis
Woman with Shoulder Pain Consults AI Doctor for Rapid Diagnosis and Plan
AI Doctor, AI Symptom Checker, AI Diagnosis, Shoulder Pain, Shoulder Impingement Syndrome, Rotator Cuff Tendonitis, Rotator Cuff Tear
Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Dr. DiPiero Video Guide to this Case Study
Resource Center
Testimonials
Share this Case Study
Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What are the symptoms of rotator cuff tendonitis?
How can volleyball cause shoulder injuries?
Is tingling in the hand related to shoulder pain?
What should I do if I have shoulder pain from weightlifting?
Does working long hours at a computer affect shoulder health?
Can shoulder injuries lead to permanent damage?
How are shoulder injuries diagnosed by AI Doctors?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
Hello! I understand you're experiencing some shoulder pain. Can you tell me more about when and how this started?
Patient
Hi! Yes, I've been having pain in my right shoulder for about a week now. It started gradually, nothing sudden.
Cody, the AI Doctor
I see. Have you been doing any activities or exercises that might have triggered this pain?
Patient
Well, I recently started playing volleyball again after a long break. I also lift weights and run regularly.
Cody, the AI Doctor
It's great to hear you're active. Is there any particular movement or activity that makes the pain worse?
Patient
Definitely. It hurts the most when I try to do anything overhead, like serving in volleyball. I also feel it when I rotate my arm outward.
Cody, the AI Doctor
Understood. Do you notice any weakness or difficulty with specific tasks due to this pain?
Patient
Yes, I do feel some weakness, especially when I'm trying to lift anything over 10 pounds.
Cody, the AI Doctor
Thank you for sharing that. Have you experienced any tingling or numbness in your hand or arm?
Patient
Yes, sometimes there's a bit of tingling in my right hand.
Cody, the AI Doctor
That's helpful information. Just to clarify, have you seen any doctors for this issue before?
Patient
No, I haven't. This is the first time I'm seeking any sort of consultation.
Cody, the AI Doctor
Got it. Could you tell me if you have any other health conditions or take any medications?
Patient
I have prediabetes and depression, but I'm not on any medications right now.
Cody, the AI Doctor
Thank you for that information. And do you find that your work as a computer programmer affects your shoulder at all?
Patient
I do spend long hours at the computer, but I haven't noticed if it's directly affecting my shoulder.
Cody, the AI Doctor
Thank you for all this information. Let me summarize what we've discussed and suggest what might be causing your shoulder pain.
Cody's AI Summary
- You're a 28-year-old woman experiencing right shoulder pain for about a week, with a gradual onset.
- The pain is aggravated by overhead activities and external rotation, and you feel some weakness when lifting over 10 pounds.
- Occasionally, you experience tingling in your right hand.
- You recently resumed playing volleyball and are also involved in weightlifting and running.
- You have prediabetes and depression but are not on medication.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Rotator Cuff Tendonitis(50 % probability)
Inflammation of the rotator cuff tendons, often due to repetitive overhead activity, leading to pain and weakness, especially noticeable with activities like volleyball.
2. Rotator Cuff Tear(30 % probability)
A tear in the rotator cuff, which can cause pain, weakness, and sometimes tingling. The weakness you experience when lifting could indicate a tear.
3. Impingement Syndrome(20 % probability)
Occurs when shoulder tendons are intermittently trapped and compressed during shoulder movements, causing pain with overhead activities.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
The patient's right shoulder pain, persisting for a week, highlights the challenges of diagnosing musculoskeletal conditions aggravated by physical activities like volleyball. AI systems are increasingly valuable in such scenarios, offering rapid, probability-based diagnoses that guide us through likely causes based on symptom patterns. Here is my further analysis:
1. Rotator Cuff Tendonitis(45% probability)
The AI Doctor initially suggested a 50% probability, which I slightly adjusted. The patient's onset of pain associated with overhead activity, such as volleyball serving, along with weakness, strongly aligns with this condition. Predisposition due to repetitive strain is likely given her recent increase in physical activity.
2. Rotator Cuff Tear(35% probability)
There's a reasonable suspicion that a partial tear could be present due to the weakness and tingling symptoms mentioned. The presence of weakness when lifting suggests more than just inflammation, supporting a potential tear diagnosis. Originally assigned a 30% probability by Cody, I increased this to reflect the concerning symptom of tingling, indicating possible nerve involvement.
3. Impingement Syndrome(15% probability)
While described as 20% probable by the AI, physical exam findings would be crucial here. Given the current data, the symptoms fit less cohesively compared to the other diagnoses, notably without evidence of severe pain during initial shoulder movement or abduction. The episodic nature of the tingling suggests a lower likelihood.
4. Other Considerations:
Bursitis or another form of soft tissue inflammation could be present, contributing to the symptoms. This is a less likely scenario but one worth considering (5% probability) in comprehensive diagnostics.
Next Steps for Evaluation
Diagnostic Testing:
Conduct a comprehensive physical examination of the shoulder to assess for areas of tenderness, range of motion limitations, strength deficits, and any signs of impingement or instability. Special tests, such as the Neer or Hawkins-Kennedy tests, can help differentiate between tendonitis and more structural injuries like tears.
Imaging Studies:
If symptoms persist or do not align clearly with clinical impressions, an MRI should be considered to assess for structural abnormalities such as rotator cuff tears or other shoulder pathologies.
Potential Treatment Modalities
Non-surgical Treatment Options:
Rest and Activity Modification: Avoid overhead painting, heavy lifting, and other activities that exacerbate symptoms while maintaining a baseline level of low-impact physical activity.
Physical Therapy: Engage in a physical therapy program tailored to improve shoulder strength and flexibility, focusing on exercises that stabilize the rotator cuff muscles and improve range of motion.
Medication: Use nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and possibly corticosteroid injections to reduce pain and inflammation.
Ice Therapy: Regularly apply ice packs to the shoulder area for 15-20 minutes several times a day, particularly following activity or when swelling is evident.
Ergonomic Adjustments: As prolonged computer use was noted, optimizing workplace ergonomics might be beneficial in reducing overall shoulder strain.
Potential for Surgical Intervention: While not immediately necessary, if a rotator cuff tear is confirmed or if persistent pain and dysfunction occur despite thorough conservative treatment, surgical options might be evaluated.
Starting with non-surgical treatments such as physical therapy and NSAIAs such as ibuprofen, and possibly corticosteroid injections might be worthwhile for symptomatic relief.
Conclusion
Incorporating clinical exam and targeted imaging will be essential in reaching a definitive diagnosis and optimizing the treatment path. Prioritizing non-invasive management initially is pivotal, and early intervention is crucial for returning to regular activities without long-term consequences.
Dr. DiPiero Video Guide to this Case Study
Resource Center
CodyMD Resources - 41 year old man with shoulder pain - CodyMD Case Study
Other Resources -Rotator cuff injury - Symptoms and causes - Mayo Clinic
American Academy of Orthopaedic Surgeons - Shoulder Pain and Common Shoulder Problems
Shoulder Impingement (Rotator Cuff Tendinitis) - Cleveland Clinic
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