What is the differential diagnosis for bilateral shoulder pain and hand weakness?

Cervical Spondylosis: This condition is a common cause of bilateral shoulder pain and hand weakness due to the compression of nerve roots in the cervical spine. It is often seen in older adults and can be attributed to wear and tear of the spinal discs and joints.

Thoracic Outlet Syndrome: This condition involves compression of the nerves and/or blood vessels that pass through the thoracic outlet, leading to pain in the shoulders and weakness in the hands.
Rheumatoid Arthritis: Although more commonly associated with small joint inflammation, rheumatoid arthritis can also cause shoulder pain and hand weakness due to inflammation and joint destruction.
Polymyalgia Rheumatica: This condition is characterized by muscle pain and stiffness, particularly in the shoulders, and can also cause hand weakness.

Spinal Cord Compression: This is a medical emergency that requires prompt attention. Compression of the spinal cord can cause bilateral shoulder pain, hand weakness, and other neurological symptoms.
Multiple Sclerosis: Although less common, multiple sclerosis can present with a wide range of neurological symptoms, including bilateral shoulder pain and hand weakness.
Guillain-Barré Syndrome: This rare autoimmune disorder can cause rapid onset of muscle weakness, including hand weakness, and can be life-threatening if not promptly treated.

Amyotrophic Lateral Sclerosis (ALS): A progressive neurological disease that affects nerve cells in the brain and spinal cord, leading to muscle weakness and atrophy, including hand weakness.
Brachial Plexitis: Inflammation of the brachial plexus, a network of nerves that conducts signals from the spinal cord to the shoulder, arm, and hand, can cause shoulder pain and hand weakness.
Lyme Disease: In rare cases, Lyme disease can cause neurological symptoms, including bilateral shoulder pain and hand weakness, particularly if left untreated.