A 47-Year-Old Woman with Left Shoulder Pain

AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 47-year-old woman who presented with pain in the left shoulder, fevers, and fatigue. Through a structured clinical approach, including targeted history, physical examination, and diagnostic testing, an illness script for the presentation emerges, and the differential diagnosis is refined. As the clinical course progresses, additional investigations provide key insights, leading to the final diagnosis.