Pseudoparalysis of the Arm
The scenario is the neonate who is not moving his arm
– fractured clavicle
– fractured proximal humerus
– fractured scapula or acromion
– osteomyelitis of the proximal humerus or clavicle
– septic arthritis of the shoulder
– weird tumour
– brachial plexus palsy
Get a history – birth history – late gestation, huge baby, shoulder dystocia
Look for infection! The proximal humerus contributes about 80% of growth – if you miss the proximal humerus infection that bags the physis, you will severely fuck up the arm.
Check the neurology – is there a discrete or diffuse brachial plexus palsy.