Prompt orthopedic referral, at least within 1 to 2 weeks, is warranted. If conservative measures fail, arthroscopy and manipulation of the shoulder under general anesthesia to break up adhesions may be considered by the orthopaedist.
Prevention is the best treatment, and the emergency physician plays a vital role. Prolonged immobilization of the shoulder or upper extremity following injury should be avoided. Prompt referral to the patient's primary care provider or orthopaedist following shoulder injuries is indicated. It allows the patient to begin early progressive motion and physical therapy, where indicated.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.