Unsual symptoms need help

by Laura
(St. Paul)

Hi,

My sister is experiencing severe pain to her left shoulder that radiates down the arm and the collar bone muscle areas worsening over past 3-4 weeks. Not cardiac.

Shoulder shrugs make the pain particularly bad (pain to collar bone muscle severe during shrug) and sitting too long. She is having numbess and tingling to her left pinky and 3rd finger. She has hot spots that come and go up and down her left arm.

Her left upper back above the scapula (trapezius?) is sometimes swollen. She gets dizzy on and off, and yesterday she said her left side of face became numb for a short time. She is only 39 y/o and otherwise good health. she had erlichiosis(sp?) once and had a car accident about 20 years ago.

She recently had an Xray of shoulder--normal; EMG --normal; and MRI of neck only --normal. The PT said her left shoulder joint was a little bit loose. Any suggestion or ideas about what could be wrong here? Or any tests that might be useful? Any help would be really greatly appreciate. My sister is suffering and it is not like her to complain (ever). I feel terrible for her. Thanks.



Hello Laura,
Ask your sister to do the following:
1. Raise her arm in front of her, to the side, and behind her back as in doing a brastrap.
2. Does placing her hand on her head relieve or aggravate the symptoms?
3. Stretch her right arm out to the side, palm forwards, extend the wrist and then laterally flex her head to the LEFT. Remember the tightness/ pain in the lower arm. That's normal. Now repeat with the naughty arm. Any difference?
4. Turn her head to the left, and then look up. What happens?
5. Run her fingers along the collar bone to both ends, the SC joint and the AC joint. What does she feel?
6. Does using the left arm hurt in the shoulder?
7. Does her arm tire very quickly when raised above shoulder level - as in hanging washing?
8. Ask her to touch the jaw joints, just in front of the ear, locate by opening and closing. Tender?
9. Headaches?
10. When lying on her back, does turning her head to the side make her dizzy?

You may need some help, computer wise, but I need to see the lateral cervical spine on the MRI. Are they digital or plain film? If you copy it and make a jpg on the desktop, you can load it directly onto this page.

Let me know.

Dr B