38 year male presented with inability to lift both shoulder above head. neck pain present.

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only inspectory findings as left shoulder rounded contour is absent, biceps b/l hypotrophied and movement till this angle is at scapulothoracic so detail history about any trauma,neurological deficit, investigations required. only on this picture long list of dd goes like brachial plexopathy, rotator cuff injury, central cord syndrome, frozen shoulder, dead arm syndrome, septic arthritis(tb) deltoid contracture etc so more history required

need to differentiate condition is in shoulder or cervical spine
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Needs more history. Is there any pain especially left shoulder? There is asymmetry in the involvement,left sided involvement is more than the rt side. Left deltoid is wasted.Tip of shoulder is elevated.Needs good history and physical findings for discussion.picture of back to look for scapula position is also important.

differential diagnosis -fascio scapula humeral myopathy bilateral frozen shoulder cervical cord compression. bilateral brachial plexus neuropathy. xetail clinical history

The patient is showing significant elevation with difficulty with arm abduction... Winging of scapula ?? Neck pain and weakness of upper extremity. Check for neurological involvement due to disc prolapse in cervical spine... Sensation in dermatome pattern,, weakness in myotome pattern, radicular pain ? Also check for myopathy, fascio scapulohumeral myopathy,

Mri cv junction shows cv anomaly (ACM) with syrinx formation in cervical cord leading to bilateral Neuropathic Arthropathy of the Shoulder (Charcot Shoulder). so basically its central cord syndrome.

Is it a painful restriction? Is pain radiating along with numbness? Could be C5 level pathology..elicit other cord symptoms/signs.

You will need detailed clinical examination to differentiate shoulder from c spine pathology
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Go foe special test and find out the cause... neck pain can be bcoz of scapular dyskinesis as patient uses his trapezius to abduct...

Detailed history is required

With detailed neurological examination

Shoulder impingement syndrome?

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