Intracranial Epidermoid Cyst Mimics Musculoskeletal Shoulder Disease: Findings from a Case Report in Physiotherapy Clinical Practice

Fabrizio Brindisino (), Mariangela Lorusso, Lorenza De Carlo, Firas Mourad, Sharon Marruganti, Valerio Passudetti and Mattia Salomon
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Fabrizio Brindisino: Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise C/da Tappino c/o Cardarelli Hospital, 86100 Campobasso, Italy
Mariangela Lorusso: Department of Clinical Sciences and Translational Medicine, University of Roma “Tor Vergata” c/o Medicine and Surgery School, 00133 Rome, Italy
Lorenza De Carlo: Fisioworld Private Practice, 86021 Bojano, Italy
Firas Mourad: Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 4671 Luxembourg, Luxembourg
Sharon Marruganti: Department of Clinical Sciences and Translational Medicine, University of Roma “Tor Vergata” c/o Medicine and Surgery School, 00133 Rome, Italy
Valerio Passudetti: Department of Clinical Sciences and Translational Medicine, University of Roma “Tor Vergata” c/o Medicine and Surgery School, 00133 Rome, Italy
Mattia Salomon: Department of Clinical Sciences and Translational Medicine, University of Roma “Tor Vergata” c/o Medicine and Surgery School, 00133 Rome, Italy

IJERPH, 2022, vol. 19, issue 20, 1-15

Abstract: Shoulder pain is often attributable to a musculoskeletal disorder, but in some instances, it may be linked to pathologies outside the physiotherapist’s area of expertise. Specifically, some intracranial problems can cause pain and disability to the shoulder complex. This case report aims to describe the clinical presentation, history taking, physical examination, and clinical decision-making procedures in a patient with an intracranial epidermoid cyst mimicking a musculoskeletal disorder of the shoulder girdle. A 42-year-old man complained of pain and disability in his left shoulder. Sudden, sharp pain was reported during overhead movements, associated with intermittent tingling of the left upper trapezius and left scapular area. Moreover, the patient reported reduced hearing in his left ear and left facial dysesthesia. The physical examination led the physiotherapist to hypothesize a pathology outside the physiotherapist’s scope of practice and to refer the patient to another health professional to further investigate the patient through imaging. It is essential for the physiotherapist to recognize when the patient’s clinical condition requires a referral to another healthcare professional. Therefore, the physiotherapist must be able to, in a timely manner, identify signs and symptoms suggesting the presence of medical pathology beyond his expertise, through appropriate medical history collection and physical evaluation.

Keywords: differential diagnosis; epidermoid cyst; physical therapy modalities; shoulder pain (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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