The physician asks the patient to abduct his arms 90 degrees to the side and flex them 30 degrees forward with his thumbs pointing to the floor. Physical examination reveals localized tenderness just below the acromion. His past medical history includes dyslipidemia and hypertension, for which he takes the appropriate medications. The patient cannot recall any traumatic events prior to the start of the pain but did experience increased discomfort after helping his daughter move into her college dorm room a week ago. The pain is worse with movement and often interferes with his sleep. A 53-year-old man comes to the office with a dull ache in his right shoulder.
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