Differential Diagnosis for a 36-year-old with Shoulder Pain
- Single most likely diagnosis
- Rotator cuff tendinitis: This is the most common cause of shoulder pain in adults, often resulting from overuse or repetitive strain on the shoulder muscles and tendons.
- Other Likely diagnoses
- Adhesive capsulitis (frozen shoulder): Characterized by stiffness and limited range of motion in the shoulder, often following trauma or inflammation.
- Bursitis: Inflammation of the fluid-filled sacs (bursae) that cushion the joints, tendons, and muscles near the shoulder joint.
- Shoulder impingement syndrome: Occurs when the tendons of the rotator cuff muscles become pinched or irritated as they pass under the acromion.
- Labral tear: A tear in the cartilage that surrounds the socket of the shoulder joint, often caused by trauma or repetitive strain.
- Do Not Miss diagnoses
- Septic arthritis: A bacterial infection within the shoulder joint, requiring prompt antibiotic treatment to prevent joint destruction.
- Fracture: A break in one of the bones surrounding the shoulder joint, such as the clavicle, scapula, or humerus.
- Axillary artery aneurysm: A rare but potentially life-threatening condition where the axillary artery becomes dilated and ruptures.
- Pancoast tumor: A type of lung cancer that can cause shoulder pain by invading the surrounding tissues and nerves.
- Rare diagnoses
- Osteonecrosis: A condition where the bone tissue in the shoulder joint dies due to lack of blood supply, often caused by trauma, steroids, or excessive alcohol consumption.
- Rheumatoid arthritis: An autoimmune disease that can cause inflammation and pain in the shoulder joint, although it is less common in this age group.
- Polymyalgia rheumatica: An inflammatory condition that causes muscle pain and stiffness, often affecting the shoulders and hips.
- Brachial plexus injury: A rare condition where the nerves that control the shoulder and arm are damaged, often caused by trauma or compression.