A shoulder pain: Not so minor - An emergency department case report study

Area of Science:

• Emergency Medicine
• Hematology

Background:

• Shoulder pain is often triaged as low priority in Emergency Departments (EDs).
• Potential underlying causes, such as sickle cell crisis, may be overlooked.
• A comprehensive approach is vital for accurate diagnosis.

Purpose of the Study:

• To highlight the importance of a thorough assessment for shoulder pain in the ED.
• To emphasize considering diverse etiologies, including hematological emergencies.
• To demonstrate how an open-minded clinical approach improves patient outcomes.

Main Methods:

• Case report of a 35-year-old male presenting with left shoulder pain.
• Initial low-priority triage due to lack of significant history or trauma.
• Advanced Nurse Practitioner's comprehensive assessment and diagnostic process.

Main Results:

• The patient's shoulder pain was eventually diagnosed as stemming from a sickle cell crisis.
• Timely and appropriate diagnosis, pain management, and follow-up were achieved.
• The case highlights the need for persistent investigation.

Conclusions:

• A proactive and inquisitive approach is essential when evaluating shoulder pain in the ED.
• Do not dismiss shoulder pain, even in seemingly healthy young patients.
• Thorough history taking and assessment are key to uncovering serious underlying conditions like sickle cell crisis.