Correct!
2. Shoulder x-ray
Although the cause of the pain is not clear from her physical examination, a shoulder x-ray is probably indicated because of her three-month history and severity of the pain. Oxycodone might be indicated to relieve the pain but only after less addicting medications have failed. Reassurance without a diagnosis is not likely to be well-received by the patient especially after 3 months of pain.
The shoulder x-ray is unremarkable. However, the radiologist notes that there is a possibility of bone loss in several thoracic vertebrae. This led to an MRI of the spine (Figure 1).
Figure 1. MRI of the cervical and thoracic spine.
Which of the following are indicated? (Click on the correct answer to proceed to the third of seven pages)