An unusual cause of shoulder pain: Winged scapula

n 18-year-old man presented with right shoulder pain nd difficulty lifting his right arm above his shoulder. He enied pain to the arm and back and stated that his houlder felt “unusual.” He was a healthy, active young ale with no medical history and no medications. He tated he played basketball the night before, but did not eport any injury during the game. The pain started hours fter the game had ended. Examination revealed winging f the right scapula (Figure 1) with decreased ability to bduct the arm over the head. A radiograph of the shouler was normal. The patient was diagnosed with long horacic nerve palsy and was instructed to follow up with hysical therapy and his primary physician.