Other causes of shoulder pain in CVA

1. How is brachial plexus and peripheral nerve injury usually diagnosed? How is it treated?
2. What are the symptoms of bicipital tendonitis and how is it diagnosed?
3. Where does HO usually appear in CVA patients?
4. How is dependent edema treated?

Answers:
1. Diagnosis is by physical exam showing segmental muscle atrophy, finger extensor contractures, delayed spasticity, and by EMG. Treatment is proper bed positioning to protect paretic arm, ROM, 45 degree abduction sling, sling for ambulation, WC armrest.
2. Symptoms are chronic pain in anterolateral shoulder, pain in abduction/external rotation, pain over bicipital groove. There is a positive Yergason's test. Diagnosis is confirmed with decreased pain after injection of tendon sheath with lidocaine.
3. In the extensor side of the elbow and in the shoulder.
4. Compression gloves, foam wedge, pneumatic compression, retrograde massage, arm elevation.