dislocated shoulder pain scale

Wait for an ambulance. Pain in your upper arm and shoulder, which is usually worse when you move them, Your age, overall health, and medical history, Your tolerance for specific medicines, procedures, or therapies, Expectations for the course of your injury, Moving the head of your upper arm bone back into your shoulder joint, usually with an anesthetic, Immobilizing your shoulder with a sling after reduction, Surgery, if nonsurgical measures do not restore stability, Swelling, pain, or both in your shoulder, arm, or hand that gets worse. Other nearby structures, including blood vessels and nerves, may also be injured in a shoulder dislocation. (This is known as the cross arm adduction test.). After your doctor has a clear understanding of your injury, your treatment will begin. 2014;22(12):761-71. doi:10.5435/JAAOS-22-12-761. Dislocation can be very painful, causing the elbow to become unstable and sometimes unable to move. The doctor may give muscle relaxers to reduce pain. Your doctor will also assess for any nerve injury. This involves a sprain of the AC ligament that does not move the collarbone and looks normal on X-rays. Apply ice or cold packs right away to prevent or reduce swelling. Rehab generally includes supervised or guided exercise at a physical therapy center. 2 Although CMS includes a pain assessment component, the visual . You may need care sooner. Once your shoulder is dislocated, physical therapy may help prevent you from dislocating it in the future. However, dislocated shoulders occur most often in people in their teens and 20s, particularly athletes involved in contact sports. Did you just suffer from a high impact injury (e.g., a fall, collision, accident or sports trauma)? Ice will reduce pain and swelling. I have dislocated my shoulder 3 times, each time a trip to the ER immediately. Symptoms [8] of a dislocated shoulder include extreme pain, weakness, swelling, bruising or redness, muscle spasms, numbness or tingling, . [1], Anterior dislocations (ASD) represent 95% of shoulder dislocation. These include: Fixing a dislocated shoulder on your own poses some challenges, including having to perform the procedure on yourself while you are injured and not having the benefit of medications used by healthcare providers to make the procedure a bit easier. The VA awards disability compensation for each Shoulder and Upper Arm condition that is service-connected.The DoD will also rate service-connected conditions as long as they also make the service member Unfit for Duty.For Reservists, the condition must have occurred in or resulted from an injury in the Line of Duty to qualify.. Take ibuprofen (Advil or Motrin), naproxen (Aleve or Naprosyn) or acetaminophen (Tylenol) for pain. By far the most common type of dislocation is anterior, meaning that the top of the arm moves abnormally far forward. We break down the different CBD sources and how to find the right gummies for you. If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). If you need to use a sling for more than 48 hours, you may have a more serious injury that needs to be checked by a doctor. Well share, Right shoulder and arm pain is pretty common, and it usually stems from rotator cuff disease. While knowing how to fix a shoulder dislocation is not knowledge that everyone really needs to know in advance, it is particularly helpful for those who engage in activities in remote areas of wilderness where help could be days away. These include: For men and women, the most common symptom is chest pain or pressure. After the shoulder heals, a physical therapist assigns exercises to stretch the shoulder and restore mobility. For 48 hours, wear a sling if it makes you more comfortable and supports your shoulder. Patients with torn rotator cuffs or fracture of the glenoid have a higher incidence of re-dislocation. If reduction efforts do not work, do not panic or force the joint into place. The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. A shoulder dislocation is usually caused by a fall or blow to the shoulder. A bed's firmness is rated on a scale of 1-10, with one being the softest and ten the hardest. . Stop, change, or take a break from any activity that may be causing your pain or soreness. Suspect physical abuse of a child or vulnerable adult when: You may be able to prevent further injuries by reporting abuse. Possible damage to rotator cuff musculature and bone. If your shoulder is pulled back too hard or rotated too far, the top of your arm might pop out of its socket. You may need care sooner. Does this movement cause sharp pain? If the symptoms get worse, seek care sooner. National Health Service UK. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. The shoulder is a ball-and-socket joint. A partially dislocated shoulder, or shoulder subluxation, means that only part of the upper arm bone is out of socket. Because it moves in several directions, your shoulder can dislocate forward, backward or downward. Keep reading: 5 exercises for rotator cuff pain . Post-operative rehabilitation following traumatic anterior shoulder dislocation: A systematic scoping review. Once a shoulder is dislocated, its more likely to feel unstable, or dislocate again. The shoulder joint is the most frequently dislocated joint of the body. Your use of this information means that you agree to the Terms of Use and Privacy Policy. These receive a code of 5203. doing strengthening exercises . If you have dislocated your shoulder, your upper arm bone (humerus) has moved out of your shoulder joint. Although consensus is available regarding nonsurgical treatment for low-grade dislocations (types 1 and 2) and surgical treatment for high-grade dislocations (types 4 to 6), controversy surrounds the indication for nonsurgical versus surgical treatment in patients with acute type 3 dislocation, with a trend toward initial nonoperative treatment . It can turn in several directions. A number of techniques can be used to reduce the shoulder. The muscles in the shoulder might spasm, which can increase the pain. Typical time periods in a sling range for 3-6 weeks if under the age of 40 and 1-2 weeks if older than the age of 40. The goal of labrum repair surgery is to reduce pain in your shoulder by restoring . Typically begin strengthening exercise in a pain-free motion with exercises for stability. If it is comfortable, place a towel or cloth under the injured forearm to create a sling, tying the ends over the opposite shoulder (one end to the front and one end to the back). A failed spinal fusion requiring it to be re-fused will recalibrate that. It might dislocate completely or partially. Have you had a shoulder injury in the past month? Go to an emergency room if you have a decreased range of motion, severe pain, and/or an abnormal appearing shoulder after a fall, a direct blow to the shoulder, seizure, or electrical shock. Based on your answers, the problem may not improve without medical care. Mayo Clinic does not endorse companies or products. First-time anterior shoulder dislocations: has the standard changed? Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms. While best done by a medical professional, you can learn how to fix a dislocated shoulder on your own should you find yourself isolated or otherwise unable to access care. This is called shoulder separation, and it can cause serious damage to the ligaments surrounding the joint, too. COVID-19: Check your symptoms and find the right care. A shoulder dislocation occurs when the round ball at the top of the upper arm bone, or humerus, leaves the socket in the shoulder blade, or scapula. Staying about the same (not better or worse)? Your shoulder joints move every time you move your arms. 2007; 89:2124-2131. Anterior Shoulder DislocationAn anterior dislocation is the most common dislocation and is caused by the arm being positioned in an excessive amount of abduction and external rotation. In that case, the shoulder, arm, or hand may feel numb, tingly, weak, or cold, or it may look pale or blue. If a bone is sticking out of the skin, don't try to push it back into the skin. http://www.uptodate.com/home. In a shoulder dislocation, the top of the humerus moves out of its normal position in the glenoid capsule. Alkaduhimi H, van der Linde JA, Flipsen M, van Deurzen DF, van den Bekerom MP. Shoulder dislocation is most common in young athletes and middle-aged people. In addition to a complete medical history and physical exam, diagnostic procedures for a dislocated shoulder usually include an X-ray. Understand your shoulder pain symptoms, including 10 causes & common questions. Register. Based on your answers, you may be able to take care of this problem at home. Bruising and swelling may occur soon after the injury. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://medlineplus.gov/shoulderinjuriesanddisorders.html), (https://medlineplus.gov/dislocations.html), (http://www.aafp.org/afp/2016/0715/p119.html), (http://orthoinfo.aaos.org/topic.cfm?topic=a00035), Numbness, tingling or weakness in the arm, hand or fingers, Immobility of the arm, or difficulty moving it. or Shoulder dislocation and reduction. Mayo Clinic does not endorse companies or products. American Academy of Orthopaedic Surgeons. Should all shoulder dislocations be closed reduced? Kelley's Textbook of Rheumatology. This should only be attempted by a medical professional. Do you have a shoulder injury or other shoulder problem? Cleveland Clinic offers expert diagnosis, treatment and rehabilitation for bone, joint or connective tissue disorders and rheumatic and immunologic diseases. Shoulder dislocation (correctly termed a glenohumeral joint dislocation) involves separation of the humerus from the glenoid of the scapula at the glenohumeral joint. Shoulder injuries most often occur during sports activities, work-related tasks, projects around the home, or falls. Accessed June 20, 2016. Frozen shoulder. Am J Sports Med. The problem probably will not get better without medical care. Looking for the best CBD gummies? But women are somewhat more likely than men to have other symptoms like shortness of breath, tiredness, nausea, and back or jaw pain. It may ooze or trickle for up to 45 minutes. Following an acute anterior glenohumeral dislocation: With acute posterior glenohumeral dislocation: Posterior dislocations are hard to reduce, attempts at closed reduction need be performed in consultation with a treating orthopaedic surgeon. Your physical therapist may also give you exercises for you to do at home. JOSPT. Damage to one or more of the four tendons that cover the shoulder joint (, Pulling or pushing bones out of their normal position among the other bones that make up the shoulder joint (, Inflammation of the sac of fluid that cushions and lubricates the joint area between one bone and another bone, a tendon, or the skin. Sports injuries. Dislocated shoulders tend to occur more often in males than in females. If you suspect a dislocated shoulder, seek prompt medical attention. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day. In this procedure, some gentle maneuvers might help move the shoulder bones back into position. A posterior shoulder dislocation often occurs due to abnormally strong contractions of the muscles that stabilize the shoulder. An orthopedist should keep an eye on older and chronic patients. Advertising revenue supports our not-for-profit mission. Cleveland Clinic is a non-profit academic medical center. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. It is very hard to move your arm. Symptoms of a dislocated shoulder will include: To better understand dislocated shoulders, shoulder anatomy and the types of dislocations have been described below. If spasms havent started, the patient may not need pain medication. Has the shoulder popped out of place before? Advertising revenue supports our not-for-profit mission. The shoulder can dislocate in an anterior (95% of shoulder dislocations), posterior, inferior direction and completely or partially. You may have to wear a splint or sling for at least a week to promote healing and minimize pain. 2017;37:47-52. Sign In Harvard Medical School: Harvard Health Publishing. Causes of shoulder dislocations follow, including trauma, iatrogenic reasons, abnormal muscle contractions, and loose joints. Always talk with your healthcare provider for a diagnosis. What Is Multi-Directional Shoulder Instability? There can be partial dislocation of the shoulder. It can take anywhere from 12 to 16 weeks to completely recover from a dislocated shoulder. A cadaveric study. The shoulder joint can also be weakened by repetitive motion, such as pitching in baseball. The affected area may be visibly disfigured with an unexplained lump or bulge. Your shoulder can dislocate in several ways: forward and downward dislocation, and backward dislocation. These include: Shock is a life-threatening condition that may occur quickly after a sudden illness or injury. The pain is disproportionate to the injury. Ice can ease swelling and reduce pain. If you cannot reach your doctor or you don't have one, seek care today. Peripheral nerve injuries are common due to traction if the, May notice posterior prominence head of humerus, Tear of subscapularis muscle (weak or cannot internally rotate). Shock is a life-threatening condition that may quickly occur after a sudden illness or injury. You may also have: Some swelling and bruising to your shoulder Numbness, tingling, or weakness in your arm, hand, or fingers What to Expect Surgery may or may not be needed after your dislocation. To further evaluate the shoulder, an MRI may be ordered. They can also be caused by the natural process of aging. Most dislocations occur through the front of the shoulder. 2016;16(4):155168. It occurs when the arm is in an abducted and externally rotated position. The first time I dislocated Mine was maybe a 5-6 on pain scale. Or they might be concerned about the cost. The Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and the Faces Pain Scale-Revised (FPS-R) are among the most commonly used measures of pain intensity in clinical and research settings. Veterans must (1) have a current, diagnosed shoulder or arm condition; (2) have experienced an event, injury, or illness during service; and (3) provide a medical nexus linking their . The visual analog scale: Categorizes pain along a horizontal line, ranging from mild to severe. Among the tests the doctor may order include X-rays, a magnetic-resonance-imaging (MRI) scan to spot tissue damage or a computerized-tomography (CT) scan, which would reveal any broken bones not seen on the X-ray. (2014). After 48 to 72 hours, if swelling is gone, apply heat. Loss of normal contour of the deltoid and acromion prominent posteriorly and laterally, Palpable fullness below the coracoid process and towards the axilla. Dislocation of your shoulder means your upper arm bone (humerus) has come out of your shoulder joint. He is the director of adult spinal deformity & complex spinal reconstruction at Massachusetts General Hospital and is on the faculty at Harvard Medical School. Causes of Arm Weakness: What to Do When Your Right or Left Arm Is Weak. It can lead to swelling, bruising, and pain. As soon as your shoulder is lodged back into your joint, your pain should subside. Steroid medicines, which may be used to treat a variety of conditions. Unfortunately, the structure of the shoulder joint makes it vulnerable to dislocation. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital. Dislocated shoulder - aftercare. After you reduce your shoulder, seek follow-up medical attention as soon as you can. That means the ball and socket bones of the shoulder are separated, with the ball of the humerus out of position. Any shoulder injury (especially a dislocated shoulder) that can't be explained, doesn't match the explanation, or occurs more than once may be caused by abuse. Wilkinson JM (expert opinion). Iowa Orthop J. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota, Products for Daily Living from Mayo Clinic Store. The rotator cuff a group of muscles and tendons surrounding the shoulder joint are more likely to tear in older patients who have suffered shoulder dislocations. Dont move the arm, and keep it close to the body. Dislocated shoulder: Lifestyle and home remedies. Contact sports injuries are a common cause a dislocated shoulder as are motor trauma and falls.[1]. 1995-2023 Healthwise, Incorporated. Prop up the area on pillows while you apply ice and anytime you sit or lie down. It's important to rest and protect the affected area. Extreme twisting of the shoulder joint can pop the ball of the upper arm bone out of the shoulder socket. In most cases, it can take anywhere from 6 weeks to 3 months before you can participate in strenuous activity again. A shoulder dislocation may stretch or tear surrounding ligaments, tendons and muscles. If you had a dislocated shoulder in the past, you are at greater risk of having it happen again. If a shoulder dislocation is diagnosed, the doctor will carefully place the arm bone back into the shoulder socket and into the correct alignment, a process called closed reduction. Its closed because it doesnt require surgery. Fibrous tissue joining the bones is often stretched or torn, complicating a dislocation. Introduction Shoulder pain is a highly prevalent condition. Smoking slows healing because it decreases blood supply and delays tissue repair. 2009;39(2):118-123. Symptoms of a dislocated shoulder include: If you believe your shoulder is dislocated, take the following steps: At the emergency room, tell the doctor how the suspected dislocation occurred, and if the shoulder was dislocated in the past. The shoulder's mobility and ball-in-socket mechanism makes it the most likely joint in the body to become dislocated. Its always best to consult with a healthcare provider before taking pain medication, especially for patients with heart disease. Partial or full fusing of the shoulder joints. In some cases, the bone can be popped back into place (reduced) without surgery. Your doctor will also observe how well you can move your shoulder and check to see if you feel any difference in pain or numbness as you move it. Place the patient in a prone position with the shoulder in 90 degrees of forward flexion and slight external rotation. Try one of these 12 great options. Last reviewed by a Cleveland Clinic medical professional on 03/19/2018. Treatment for a dislocated shoulder depends on the severity of the injury. Blood is quickly soaking through bandage after bandage. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Went snowboarding 9 days in a row in a sling with no pain. Surgical repair may be required for dislocation treat complications and associated injuries (see above). Based on your answers, you may need care right away. Home treatment often can help relieve minor aches and pains. American Academy of Orthopaedic Surgeons: OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/dislocated-shoulder/. This attachment allows the shoulder to remain stable in the joint when you move the shoulder in many different directions. The type and duration of your rehab will depend on the extent of your injury. He currently practices as a hospitalist at Newton Wellesley Hospital. You will feel pain and weakness in your . Click here for an email preview. Dont try to jam the shoulder back into place, because that can damage blood vessels, muscles, ligaments and nerves. Any event that causes severe bleeding that you cannot control. "Somewhat hard" means you can move it at least a little, though you may have some pain when you do it. A partial dislocation is when the head of your upper arm is partially out of your shoulder socket. 2009; 37:1309-1316. The Musculoskeletal System is vast and complex, consisting of . (2014). New masking guidelines are in effect starting April 24. Clinical outcomes were assessed using the shoulder range of motion (ROM), visual analogue scale (VAS) for pain and satisfactory score, American Shoulder and Elbow Surgeons (ASES) score, and Simple Shoulder . They may cause tendons to rub or scrape against a part of the shoulder blade called the acromion. You can try this method for 20 minutes at a time as you feel the need. information highlighted below and resubmit the form. Instead, create a calm environment, removing anyone causing undue stress, anxiety, or agitation. Try our AI assistant here. Healthline Media does not provide medical advice, diagnosis, or treatment. It occurs when a childs elbow is pulled and partially dislocates. A dislocated shoulder is an injury in which the upper arm bone comes out of the shoulder blade socket. Shoulder Popping Symptoms, Causes, & What to Do. Maintaining muscle strength and flexibility can help prevent shoulder dislocations. Arm blue, very pale, or cold and different from other arm. http://www.uptodate.com/contents/search. It is a particularly important pathology to be able to recognize in the field due to the prevalence of the injury as well as the high recurrence rate. Once the shoulder is back in place, any severe pain stops almost immediately. Does your child seem to be protecting the arm or not using it normally? If symptoms get worse or you have any concerns, call your doctor. You doctor may give you a mild sedative or a muscle relaxer beforehand to help reduce any discomfort. If the arm is in a cast, splint, or brace, follow the instructions you got about how to loosen it. As you do this, the shoulder should pop back into place. Closed reduction (shoulder). It has three main bones: the upper arm bone (humerus), the collarbone (clavicle), and the shoulder blade (scapula). AAROM to achieve a full range of motion when stretching is permitted, passively stretch the posterior joint capsule through the use of joint mobilizations or self-stretching. Not feeling alert or able to think clearly. Advertising on our site helps support our mission. This can be serious. If the injury doesnt heal as expected, a doctor might order a scan to find tissue tears not seen earlier. Symptoms of a dislocated shoulder will include: Decreased movement: You will have decreased ability to move the arm at the shoulder. Numbness, tingling, or weakness for more than 1 hour. Thus, it will take approximately 6-8 weeks to get the shoulder moving after a Shoulder Dislocation. Don't massage the affected area if it causes pain. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. An anterior dislocation typically occurs when the arm is twisted while it is stretched straight out. If a dislocation is severe enough, it is. The shoulder joint a ball-in-socket mechanism, with the round top of the arm bone fitting into a groove in the shoulder blade is the most mobile joint in the body. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Dislocation is often caused by a significant force that separates your shoulder joint's ball (the top rounded portion of your upper arm bone) from your joint's socket (glenoid). If the joint doesn't pop back instantly, take several moments to relax, breathe in slowly and deeply, and try again. [1], Extreme rotation can cause the humeral head to come out of the glenoid labrum. These uncontrollable movements can worsen your pain. Complete dislocation is when the head of your upper arm is completely out of your shoulder socket. Research comparing the effect of different rehabilitation programmes is lacking as is evidence to guide post-operative rehabilitation. Pain, numbness, or tingling: Shoulder dislocation causes severe pain, particularly with attempts to move the shoulder. In: StatPearls. You can also try a hot pack on the shoulder. Shoulder injuries most often occur during sports activities, work-related tasks, projects around the home, or falls. . The doctor will order another X-ray to make sure the reduction was successful. In a partial dislocation, the upper arm bone is partially in and partially out of the shoulder socket. Talk to your doctor about the options available to you. Engaging in these activities before you are cleared by your doctor can damage your shoulder even more. Have you had shoulder surgery in the past month? A sudden (acute) injury may occur from a fall on an outstretched arm, a direct blow to the shoulder, or abnormal twisting or bending of the shoulder. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Bursitis. Numbness, tingling, and an abnormal appearance of the shoulder characterized by bruising or swelling may also occur. Symptoms of a dislocated shoulder include: Extreme pain and/or weakness Swelling Bruising or redness Muscle spasms Numbness, tingling or weakness in the arm, hand or fingers Immobility of the arm, or difficulty moving it Shoulder visibly out of place If you believe your shoulder is dislocated, take the following steps: information and will only use or disclose that information as set forth in our notice of Dislocated shoulder: Treatments and drugs. This occurs when the outer end of the collarbone (clavicle) separates from the end (acromion) of the shoulder blade because of torn ligaments. You should contact your healthcare provider if you have the following symptoms: Dislocation of your shoulder means your upper arm bone (humerus) has come out of your shoulder joint. Faces pain scale - revised (FPS-R . For successful healing and eventual normal function a structured course of physical therapy is needed to reduce muscle wasting and maintain mobility. The shoulder is a "ball and socket" joint, with the ball of the upper arm bone (humerus) fitting into a socket (glenoid capsule) on the shoulder blade. If one of the nerves in the area of the . The shoulder joint is stabilized by rotator cuff muscles, which are sometimes damaged when dislocation occurs. . Isometrics can be incorporated for the rotator cuff and biceps musculature.eg Codman Exercises; AAROM for external rotation (0-30) and forward elevation (0-90)Phase 2 (6-12 weeks)[7]: Goal is to restore adequate motion, specifically in external rotation, Phase 3 (12-24 weeks)[7]: Successful return to sports or physical activities of daily living, Management for posterior dislocation follows the same progression as anterior protocol, except for the following guidelines:a. Posterior glide is contraindicatedb. Severe or sudden numbness or weakness in the whole arm or hand. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Turk J Emerg Med. Anterior shoulder Instability. Your healthcare provider discusses with you specific treatment for a shoulder dislocation, based on: Maintaining muscle strength and flexibility can help prevent shoulder dislocations. Surgery may be required in some cases. Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. Turk J Emerg Med. Are there red streaks leading away from the area or pus draining from it? Recent progress in surgical procedures and diverse populations presenting with ASD partly causes this variability[8]. (2014). How long have you had trouble moving your shoulder? Keep the area raised if you can. Are you having trouble moving your shoulder? Is your shoulder pain constant or come-and-go? Separation of the shoulder. Any injury cannot be explained or does not match the explanation. Firestein GS, et al. However, if no medical help is available, you can proceed with trying to reduce the shoulderalbeit with extreme caution. Bruising and swelling may occur soon after the injury. In addition, shoulder dislocation itself can loosen the shoulder joint and predispose individuals to repeated dislocation in the future. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Normally, it takes about two weeks of rigorous physical therapy to get the shoulder moving again without much pain or difficulties. Shoulder dislocation is almost always caused by some kind of severe acute trauma, but there are exceptions. Shoulder problem may have been caused by abuse.

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