NP Medical News about neck and shoulder pain; septic arthritis

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New-onset neck and shoulder pain in an arthritis patient
The Clinical Advisor, 07/21/09

Dunn Y et al. – Mr. G, aged 74, came to the ambulatory–care clinic initially for pain in his right shoulder and neck. The shoulder pain had started about one month earlier, when he developed a "grapefruit–sized" lump in the area, and was worse with movement. The patient denied fever, chills, and any associated trauma. Two weeks later, after starting ciprofloxacin for a UTI secondary to methicillin–sensitive Staphyloccocus aureus (MSSA), the lump was a little smaller but still painful. The patient's neck pain had become severe four months before his visit. Past medical history included psoriatic and rheumatoid arthritis (RA) for more than 25 years...Septic arthritis due to S. aureus can occur as a complication in any patient with RA. Patients with underlying arthritis who complain of acute pain in a single joint should have the joint aspirated and the synovial fluid sent for culture.

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