sk732 Posted October 15, 2015 Share Posted October 15, 2015 I was on an evening shift yesterday when I pick up this 20 year old complaining of am shoulder pain for 2 days and that "my collar bone is floating". Denies trauma, heavy lifting, side sleeping, arthritis, fevers, chills, sweats, weight changes or joint laxity. General review of systems is negative. He's AVS(N)/NAD; tall, thin dude, some thoracic scoliosis. Relative arachnodactyly, though not as profound as I've seen before. Just eyeballing him, he's got a 2nd Deg AC separation on the ® with impingement in greater than 85Deg abduction. (N)/= power/tone/sensation otherwise, no other joint laxities elicited. (N) lung and heart sounds without murmur. XRay confirmed the AC separation and CXR showed some kypphoscoliosis and that lateral views showed a very narrow chest. Kid didn't have a real family doctor to follow up with, so I took the liberty of sending him to medical genetics to formally rule in/out Marfanism or Ehler-Danlos. Anyone else around here see a spontaneous AC separation before? Link to comment Share on other sites More sharing options...
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