Description
This BOA 2024 presentation by Mr Radhakant Pandey outlines a clinical case of a 50-year-old male presenting with severe shoulder pain and limited range of motion, and the process of diagnosing a significant underlying issue—a malignant tumor in the subscapularis muscle. Mr Pandey emphasizes the importance of having a high index of suspicion when acute pain and motion restriction occur, especially in middle-aged patients. Multiple pathologies such as frozen shoulder, osteoarthritis, and cuff tears were considered, but failure to respond to standard tests led to further investigation. An X-ray was normal, but subsequent MRI scans revealed a large, aggressive tumor.
Mr Pandey highlights that shoulder and elbow regions are common sites for primary tumors, advocating for comprehensive imaging—preferably MRI over ultrasound—to ensure no tumors are overlooked. The presentation also delves into surgical intervention strategies involving multidisciplinary teams including vascular surgeons, particularly for the safe excision of tumors located near critical neurovascular structures.
Success stories are shared about patients who underwent tumor resections followed by reconstructions using innovative prosthetics that have significantly improved their quality of life, especially in maintaining functions like shooting—demonstrating an effective intersection of orthopedic surgery and oncology. Mr Pandey concludes by urging orthopedic surgeons to differentiate benign conditions from potentially critical tumors and to collaborate with specialized units to enhance patient care outcomes.