What's the Dx and Rx?

Pain in left elbow joint and shoulder joint since 2 month. Age 30years, female, house wife. Chief Complaints Severe pain in left hand ( elbow to shoulder). No any other complain. History Near about 7-8 year's ago she was drop out the bicycle and rolling downwards to the 12-15 ft. Vitals Every thing is normal. Physical Examination Problem with hands upward and backwards move. Investigations X-RAY is attached Diagnosis Please suggest Management Please suggest

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Possibly muscular etiology. See if pain relieves with analgesics and muscle relaxant. Sos MRI shoulder joint.

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No bony involvement. Muscular pain. Physio exercise. NSAID.

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Bony lesion not found Give symptomatic treatment

Thanks Dr. SANDEEP GHODEKER, Dr. Dinesh Gupta , Nihar Ranjan mohanty
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NCS will help Check all nerves.

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Take acetaminophen and ibuprofen and naproxen sodium and taking Antiinflammatory drugs to relieve the pain and cold compress reduce the patient swelling elbow muscular..

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Tendonitis or Impingement Syndrome

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Elbow muscular pain then patients upward and backward moves and elbow bone pain..

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No bony involvement

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i unable to seen x-ray properly, movement restriction---muscle spasms,malaligned joint positions,malnutrition ..!

Etiology seems to be musculotendinous Assess and manage for same using - Pain meds - Physical exercises - physical therapy

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