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- <p>A 67-year-old man with thoracolumbar scoliosis, poor mobility, and history of frequent<br>falls presented to the emergency department with 2 months of left shoulder pain, stiff-<br>ness and reduced range of motion, and numbness and paresthesias in his left upper<br>extremity. Ten years prior to presentation, he underwent surgical decompression for<br>syringomyelia. A magnetic resonance imaging (MRI) scan of his cervical and thoracic<br>spine performed 2 years prior to presentation revealed a recurrent syrinx extending from<br>Cl<br> C1 to T11, which was not resected because it did not cause symptoms at that time. On<br>physical examination, he had mild tenderness to palpation and reduced range of motion<br>of the left shoulder with abduction and flexion limited to 120° (normal range of motion,<br>180°). The left scapular muscles were atrophic, and pain and temperature sensation<br>were reduced in his proximal left arm, and dorsal aspect of his left shoulder. His complete<br>blood cell count, serum glucose levels, C-reactive protein levels, and erythrocyte sedi-<br>mentation rate were normal. Results of tests for rheumatoid factor and antinuclear anti-<br>body were negative. Left shoulder radiograph showed complete absence of the left<br>humeral head and a well-demarcated smooth osseous margin of the proximal humerus<br>with associated soft tissue swelling and periarticular calcification (Figure 1). A chest<br>radiograph taken 2 years prior revealed a normal left shoulder joint. The patient was hos-<br>pitalized for further evaluation and treatment.</p>
+ <p>A 67-year-old man with thoracolumbar scoliosis, poor mobility, and history of frequent<br>falls presented to the emergency department with 2 months of left shoulder pain, stiff-<br>ness and reduced range of motion, and numbness and paresthesias in his left upper<br>extremity. Ten years prior to presentation, he underwent surgical decompression for<br>syringomyelia. A magnetic resonance imaging (MRI) scan of his cervical and thoracic<br>spine performed 2 years prior to presentation revealed a recurrent syrinx extending from<br>Cl C1 to T11, which was not resected because it did not cause symptoms at that time. On<br>physical examination, he had mild tenderness to palpation and reduced range of motion<br>of the left shoulder with abduction and flexion limited to 120° (normal range of motion,<br>180°). The left scapular muscles were atrophic, and pain and temperature sensation<br>were reduced in his proximal left arm, and dorsal aspect of his left shoulder. His complete<br>blood cell count, serum glucose levels, C-reactive protein levels, and erythrocyte sedi-<br>mentation rate were normal. Results of tests for rheumatoid factor and antinuclear anti-<br>body were negative. Left shoulder radiograph showed complete absence of the left<br>humeral head and a well-demarcated smooth osseous margin of the proximal humerus<br>with associated soft tissue swelling and periarticular calcification (Figure 1). A chest<br>radiograph taken 2 years prior revealed a normal left shoulder joint. The patient was hos-<br>pitalized for further evaluation and treatment.</p>
<ul>
<li><a href="/papers/Radiographic%20Absence%20of%20the%20Left%20Humeral%20Head.pdf">报告原档</a></li>
</ul>