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    • #38283
      Son Nguyen

      Hi Birdies!

      I was hoping someone could shed some light on this case I scanned yesterday.

      Patient lifted a heavy object 2 days ago, now has severe pain and firm swelling over trapezius muscle 10/10.
      Also some tenderness over AC jont 8/10. General severe restricted painful movements.

      – Rotator Cuff NAD, GHJ NAD
      – AC joint distended with echogenic foci within, stable ?synovitis ?arthropathy
      – Trapezius muscle enlarged with increased echogenicity.

      What would be the cause of trapezius appearance?

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    • #38364
      Stephen Bird


      The AC joint looks degenerative and the patient is 57 years old so this is common.

      The trapezius muscle appearance is unusual,

      I don’t think I have seen a trapezius tear before but perhaps you have just shown one to me.
      Trapezius is such a big muscle I don’t think of it as being a muscle that tears.

      The ultrasound appearance is more consistent with a delayed onset muscle soreness (DOMS) event rather than a tear.

      Was there a history of repeated lifting on the day causing a muscle overloading injury?

      Or was it a single lift?


      • #38422
        Son Nguyen

        Thanks for the reply Steve.

        I can’t recall exactly what he was doing beforehand. He mentioned lifting quite a heavy gate over a short period only.
        DOMS could well be a good differential. His extreme tenderness and restricted ROM was also odd.

    • #38525
      Stephen Bird

      Yes, it is an unusual injury,

      Not a muscle I see getting into trouble often,

      If he has an MRI it would be interesting to see the result.


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