Cervicodorsal sprain/strain, thoracic spine sprain/strain, rib sprain/strains, cervical radiculopathy, myofascial pain syndrome, Shoulder Crossed Syndrome.

Physical Exam Findings:

Examination of this patient demonstrated a cervical goose-neck posture with bilateral shoulder rounding. His right shoulder was higher than the left with associated muscle contractions of the upper trapezius, bilateral pectoralis muscles and SCMs. Spinal fixations were evident in the anterior cervical spine as anterior flexion fixations as well as in the upper thoracic spine. Scapula fixations existed whereas the scapula was protracted and elevated and fixated laterally. There were bilateral rib sprains with the right rib region most affected. There were multiple trigger points.

Cervical compression tests were negative for radiculopathy. Cervical ranges of motion were limited in lateral flexion and rotation bilaterally.

Question: What is your working diagnosis at this point?