Brian was taken to a Pediatric Practice in January 2003 with complaints of right shoulder pain which was attributed to a hockey injury. Chris was examined by a nurse practitioner. On exam, swelling of the right shoulder blade was noted, but the patient had full range of motion and equal strength bilaterally. Ibuprofen 600 mg q 8 hours prn was prescribed.
Brian returned in March 2003 with continued swelling or the right scapula. At this time he was seen by the collaborating doctor. The doctor diagnosed a rhomboid muscle strain and prescribed Vicodin, ice, rest and continued use of the Ibuprofen.
Brian returned the next week with the same complaints and was seen by the same physician seen previously. The MD prescribed physical therapy as the next treatment plan.
Brian continued to have pain two months later and the doctor referred him to a sports medicine physician.
Brian went to see the sports medicine physician who recommended an orthopedic surgeon.
About the same time (sports medicine physician visit) Brian went to a rehabilitation specialist who ordered x-rays of the thoracic spine. These x-rays revealed a large mass in the right, upper lobe of his lung. Brian underwent a lung and bone marrow biopsy and was diagnosed with Ewing’s sarcoma. Further testing showed that the cancer had metastasized to other parts of his body.