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ARTICLE |

Diagnosis of Persistent Shoulder Pain FREE

Arthur Ecker, MD
JAMA. 1984;252(24):3365-3365. doi:10.1001/jama.1984.03350240015013
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To the Editor.—  An additional diagnosis to consider in the case of persistent shoulder pain1 is reflex sympathetic dystrophy.For such diagnosis, the following special tests are useful: bone scan (scintigraphy), which may show hyperfixation of radioactive phosphate2; repetition of roentgenography of the shoulder, which may now show localized osteopenia (Sudeck's atrophy); and thermography, either telethermography or liquid crystal contact thermography,3 which may reveal either increased or decreased cutaneous temperature at the shoulder. In 27 cases of shoulder-hand syndrome, thermography results were positive in 18 of 25 studies of the back of the shoulder and in 11 of 18 studies of the front of the shoulder.3

REFERENCES

 Persistent shoulder pain: Differential diagnosis . JAMA 1984;;251:1344.
Doury P, Dirheimer Y, Pattin S: Algodystrophy . New York, Springer Publishing Co Inc, 1981;, pp 14, 55.
Ecker A:  Reflex sympathetic dystrophy: Thermography in diagnosis . Psychiatr Ann , in press.

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 Persistent shoulder pain: Differential diagnosis . JAMA 1984;;251:1344.
Doury P, Dirheimer Y, Pattin S: Algodystrophy . New York, Springer Publishing Co Inc, 1981;, pp 14, 55.
Ecker A:  Reflex sympathetic dystrophy: Thermography in diagnosis . Psychiatr Ann , in press.
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