Differential Diagnosis for Shoulder Pain without Fracture or Dislocation
Single Most Likely Diagnosis
- Rotator Cuff Tendinitis: This is the most common cause of shoulder pain, resulting from inflammation of the tendons surrounding the shoulder joint. It is often related to overuse or repetitive strain injuries.
Other Likely Diagnoses
- Adhesive Capsulitis (Frozen Shoulder): Characterized by stiffness and limited range of motion in the shoulder, often following a period of immobility or trauma.
- Bursitis: Inflammation of the fluid-filled sacs (bursae) that cushion the joints, tendons, and bones near the shoulder joint, typically caused by repetitive motion or direct pressure.
- Impingement Syndrome: Occurs when the tendons of the rotator cuff muscles become pinched or irritated as they pass under the acromion, a part of the shoulder blade.
- Labral Tears: Tears in the labrum, a cartilage structure surrounding the socket of the shoulder joint, which can cause pain and instability.
Do Not Miss Diagnoses
- Thoracic Outlet Syndrome: A condition where the nerves and/or blood vessels between the neck and shoulder are compressed, leading to pain, numbness, and tingling in the arm and hand.
- Referred Pain from the Cervical Spine: Pain originating from the neck (cervical spine) that radiates to the shoulder, which could be due to a herniated disc, spinal stenosis, or other cervical spine issues.
- Polymyalgia Rheumatica: An inflammatory condition that causes widespread muscle pain, particularly affecting the shoulders and hips, and can be associated with giant cell arteritis.
- Infection or Septic Arthritis: Although less common, infections within the shoulder joint can cause severe pain and require urgent medical attention.
Rare Diagnoses
- Osteonecrosis (Avascular Necrosis) of the Humeral Head: A condition where the blood supply to the humeral head is disrupted, leading to bone death and potentially causing shoulder pain.
- Tumors: Both benign and malignant tumors can occur in the shoulder region, causing pain and other symptoms.
- Neurological Conditions: Certain neurological conditions, such as brachial plexitis or neuropathies, can cause shoulder pain, although these are less common causes.