Chronic Shoulder Pain in a Patient Receiving Maintenance Dialysis: A Quiz
A 65-year-old man with end-stage kidney disease receiving maintenance hemodialysis (HD) for 28 years was evaluated for an 8-year history of chronic right shoulder pain and decreased range of motion. His medical history was significant for secondary hyperparathyroidism, nonobstructive coronary artery disease, atrial flutter, seizure disorder, cirrhosis with hepatitis C, osteoarthritis, and depression; past surgical history was notable for left nephrectomy for renal cell carcinoma, bilateral total hip arthroplasty for left femoral neck fracture and right avascular necrosis, multiple arteriovenous fistulas in both arms, bilateral carpal tunnel syndrome (CTS) release, and screw fixation of nonhealing left fifth metatarsal fracture.