The Shoulder

Elderly patients, patients with immuno-deficiency and intravenous drug abusers.

The patient complains of severe local pain, local swelling and tenderness and general illness (fever, chills and sweating).

A combination of cervical signs, shoulder signs and shoulder girdle signs.

A passive and active pull on the sternocleidomastoid and scaleni muscles provokes pain during passive, active and resisted movements of the cervical spine.
Active as well as passive elevation of the arm is very much limited.
All active and passive movements of the scapula elicit pain and are limited.
The sternoclavicular joint is warm, swollen en tender to the touch.

Aspiration and antibiotics