Post-traumatic shoulder movement disorders: A challenging differential diagnosis between organic and functional

Area of Science:

• Neurology
• Orthopedics
• Psychiatry

Background:

• Peripheral trauma is a potential, though controversial, trigger for movement disorders.
• Functional (psychogenic) disorders can present similarly in some patients.
• Shoulder movement disorders following trauma are uncommon and diagnostically challenging.

Observation:

• Three cases of shoulder movement disorders post-trauma are presented.
• Two patients had a history of recurrent shoulder dislocation, diagnosed with Ehlers-Danlos syndrome.
• One patient sustained a shoulder injury from repeated falls during cheerleading.
• Clinical features suggested functional etiology in two patients, but physiological studies were inconclusive.

Findings:

• Physiological studies failed to provide objective evidence of a functional disorder in all three patients.
• The complex pathophysiology of post-traumatic shoulder movement disorders presents diagnostic challenges.
• These movement disorders can lead to prolonged pain and handicap.

Implications:

• Highlights the diagnostic complexity of shoulder movement disorders after trauma.
• Suggests the need for comprehensive evaluation beyond initial clinical suspicion of functional disorders.
• Underscores the potential for treatment resistance once these movement disorders are established.