Differential Diagnosis for Pitcher's Shoulder Pain
- Single Most Likely Diagnosis
- Shoulder impingement syndrome: This is the most common cause of shoulder pain in pitchers, resulting from repetitive motion and overhead throwing, leading to inflammation and irritation of the rotator cuff tendons.
- Other Likely Diagnoses
- Rotator cuff strain or tear: The repetitive stress of pitching can cause strain or tears in the rotator cuff muscles or tendons, leading to pain and weakness.
- Labral tear: The labrum is a cartilaginous structure that surrounds the socket of the shoulder joint, and repetitive throwing can cause tears in this area, leading to pain and instability.
- Scapular dyskinesis: Abnormal movement patterns of the scapula can put additional stress on the shoulder joint, leading to pain and dysfunction.
- Do Not Miss Diagnoses
- Shoulder instability or dislocation: Although less common, shoulder instability or dislocation can occur in pitchers, especially if they have a history of trauma or previous instability.
- Osteonecrosis or avascular necrosis: This is a rare but potentially devastating condition that can occur if the blood supply to the humeral head is compromised, leading to bone death and collapse.
- Thoracic outlet syndrome: This condition involves compression of the nerves and blood vessels that pass through the thoracic outlet, which can cause pain, numbness, and weakness in the shoulder and arm.
- Rare Diagnoses
- Septic arthritis or osteomyelitis: These are rare but potentially serious infections that can occur in the shoulder joint or bone, requiring prompt diagnosis and treatment.
- Tumors or cysts: Although rare, tumors or cysts can occur in the shoulder region, causing pain and dysfunction.
- Nerve entrapment or neuropathy: Conditions such as suprascapular nerve entrapment or neuropathy can cause pain, weakness, and numbness in the shoulder and arm.