Differential Diagnosis for Atraumatic Shoulder Pain in Teenagers
Single Most Likely Diagnosis
- Subacromial Bursitis or Rotator Cuff Tendinitis: This is a common cause of shoulder pain in teenagers, often related to overuse or repetitive activities. The pain is typically localized to the shoulder region and may worsen with movement.
Other Likely Diagnoses
- Adhesive Capsulitis (Frozen Shoulder): Although more common in adults, teenagers can also experience adhesive capsulitis, especially if they have a history of trauma or immobilization. The condition is characterized by stiffness and limited range of motion in the shoulder.
- Labral Tears: Labral tears can occur in teenagers, often due to sports-related injuries or repetitive movements. The pain is usually deep and localized to the shoulder joint.
- Osteochondritis Dissecans: This condition involves a defect in the cartilage and bone of the joint, often caused by repetitive stress or trauma. It can lead to pain and limited mobility in the affected joint.
Do Not Miss Diagnoses
- Septic Arthritis: Although rare, septic arthritis is a medical emergency that requires prompt treatment. It can present with sudden onset of pain, swelling, and limited mobility in the affected joint.
- Bone Tumors (e.g., Osteosarcoma, Ewing's Sarcoma): Although rare, bone tumors can cause shoulder pain in teenagers. It is essential to consider this possibility, especially if the pain is persistent, worsening, or accompanied by other systemic symptoms.
- Infectious Diseases (e.g., Lyme Disease, Tuberculosis): Certain infectious diseases can cause shoulder pain, and it is crucial to consider these possibilities, especially if the patient has a history of exposure or systemic symptoms.
Rare Diagnoses
- Sickle Cell Disease: This genetic disorder can cause vaso-occlusive crises, leading to pain in various joints, including the shoulder.
- Fibromyalgia: Although more common in adults, fibromyalgia can occur in teenagers, causing widespread musculoskeletal pain, including shoulder pain.
- Polymyalgia Rheumatica: This inflammatory condition is rare in teenagers but can cause shoulder pain, stiffness, and limited mobility.
- Brachial Plexitis (Neuralgic Amyotrophy): This condition involves inflammation of the brachial plexus, leading to shoulder pain, weakness, and limited mobility.