PAIN IN THE SHOULDER AND ARM FROM NEUROLOGICAL INVOLVEMENT

Pain in the shoulder and arm can often be traced to disease involving the vertebral column, the brachial plexus, or the peripheral nerves of the upper extremity. Case histories are given to illustrate the appearance of such pain as an early symptom in herniation of the intervertebral disk between the seventh cervical and first thoracic vertebrae, in intraspinal neurofibroma at the level of the third and fourth cervical vertebrae, in carcinoma of the pulmonary apex, in aneurysm of the subclavian artery, and in neurogenic sarcoma involving the radial nerve just above the elbow. Exquisite localization and sensitivity characterize small glomangiomas occurring in the subcutaneous tissues and small neurogenic sarcomas on subcutaneous nerves. Treatment of any of these conditions is most difficult unless the diagnosis is accurate. When a suitable lesion is found, operation often affords prompt and permanent relief of symptoms.