{"text":"Gr\u00e9at\u00e9r Glasgiow \n) \u201c7iand Clyde 7 \nTRAUMA AND ORTHOPAEDICS . \n: Glasgow Royal Infirmary \n84 Castle Street \nGLASGOW G4 0SF \nTEL: 01412115186 \nFAX: 0141211 4060 \n\" ESPLEDSHOULDERCLINIC ___ \n2\/ Re: Agnes Clelland (Cont'd) . \nOn examining her shoulder she elevated to 90\u00b0befor e expefiencing some pain. | could bring her through \ninto about 120\u00b0which is matched by her unaffected side. She experienced pain on end range external \nrotation bilaterally and she brought her hand round her back to the level of her belt. :She advises that her \nshoulder has been like this for a long time: \nWith reg'ard to her neural examination she seemed to have diminished sensation in the C6 distribution of \nher right arm from her elbow down to her fingers. Her reflexes were normal bilaterally. 1 found it difficult \n. to assess if she had global weakness in the arm or if it was more pain inhibited. \nX-rays today show widespread degenerate change throughout the cervical spine. \nThere does seem to be an underlying chronic pain picture here but in light -of the description of her \nsymptoms and the loss of sensation | am referring her for an MRI to establish if she has right C6 nerve \nroot impingement or indeed more generalised stenosis of the neck. \nShe will be reviewed following Her MRI scan. \nYours sincerely y \nL. MERCER \nExtended Scope Practitioner 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