A 74 year old woman presented to the emergency department complaining of two weeks of left shoulder pain. The pain was sharp, 8 out of 10 in intensity, located in the left shoulder, made worse with breathing, and associated with mild chest discomfort, diaphoresis, and neck pain. There was no radiation and the pain was not worsened with exertion. The patient has a history of Warthin tumor of the left parotid gland and had undergone laryngoscopy and polypectomy two weeks prior to presentation. Around this time she developed the shoulder pain along with overall weakness. At the time of presentation she reported the pain was only present with deep breathing. She denied any shortness of breath, headache, lightheadedness, dizziness, or cough