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A 46-Year-Old Man With Excruciating Shoulder Pain*

Eric J. Olafsson, MD; Tallal Zeni, MD; David S. Wilkes, MD, FCCP
Author and Funding Information

*From the Division of Pulmonary and Critical Care Medicine (Drs. Olafsson and Wilkes) and the Department of Surgery (Dr. Zeni), Indiana University School of Medicine, Indianapolis, IN.

Correspondence to: David S. Wilkes, MD, FCCP, Division of Pulmonary Medicine and Critical Care Medicine, Indiana University School of Medicine, Van Nuys Medical Sciences Building MS224, 635 Barnhill Dr, Indianapolis, IN 46202-5120; e-mail: dwilkes@iupui.edu



Chest. 2005;127(3):1039-1044. doi:10.1378/chest.127.3.1039
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A 46-year-old man with no significant medical history presented to his local emergency department complaining of excruciating right shoulder pain. The patient was in his usual state of excellent health until 4 days prior, when right shoulder pain developed while he was using a chainsaw to cut wood. The next day, flu-like symptoms developed with fevers, chills, and headache. An MRI revealed that the right pectoralis major was torn from its attachment to the acromion. His shoulder pain intensified despite treatment with hydrocodone and acetaminophen, and the flu-like symptoms progressed over the next 2 days. Finally, on the day of hospital admission, he was weak and unable to arise out of bed. He was taken by family members to the local emergency department.

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