Differential Diagnosis for Left Shoulder Pain
The patient presents with left shoulder full range of motion with pain on extension, faint bruising over the scapula region, and increased tenderness with palpation over the posterior shoulder. Based on these symptoms, the following differential diagnoses are considered:
- Single most likely diagnosis
- Scapular Contusion or Bruise: The presence of faint bruising over the scapula region and tenderness to palpation suggests a traumatic injury to the scapula, which is consistent with a contusion or bruise. The pain on extension may be due to the movement of the scapula and the surrounding muscles.
- Other Likely diagnoses
- Rhomboid Strain: The rhomboid muscles are located in the posterior shoulder region and play a crucial role in scapular movement. A strain in these muscles could cause pain and tenderness, especially with palpation and movement.
- Trapezius Strain: The trapezius muscle is another muscle in the posterior shoulder region that could be strained, leading to pain and tenderness.
- Scapulothoracic Bursitis: Inflammation of the bursa between the scapula and the thoracic wall could cause pain and tenderness in the posterior shoulder region.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Scapular Fracture: Although less likely, a fracture of the scapula could present with similar symptoms and would require prompt medical attention to prevent further complications.
- Pneumothorax: Trauma to the chest or shoulder region could potentially cause a pneumothorax, which is a life-threatening condition that requires immediate medical attention.
- Rare diagnoses
- Scapular Osteochondroma: A rare benign tumor that could cause pain and tenderness in the posterior shoulder region.
- Ewing's Sarcoma: A rare malignant tumor that could present with pain and tenderness in the shoulder region, although it is extremely uncommon in this location.