PMH, medications, allergies were reviewed.

Physical Exam:

Vital signs were reviewed.

RESPIRATORY: The breath sounds are equal bilaterally with normal amplitude. There are no crackles, rubs, or wheezes.
CARDIOVASCULAR: The heart sounds are normal. There are no murmurs, rubs, clicks or gallops.
MUSCULOSKELETAL: The left shoulder is tender in the left subscapularis and the left deltoid bursa.

I cleaned the left shoulder with betadine and then alcohol. I injected 40 mg of Kenalog with 1/2 ml of 0.5% bupivicaine into the left subscapularis bursa and I injected 40 mg of Kenalog with 1/2 ml of 0.5% bupivicaine into the left deltoid bursa.

Impression:

1. 

Plan:

1. 

Samuel T. Bowen, MD