Differential Diagnosis for Shoulder Pain with Radiating Symptoms
Single Most Likely Diagnosis
- Musculoskeletal Strain or Sprain: This is the most likely diagnosis due to the description of a "knot feeling" and pulling sensation from the shoulder blade down to the elbow and fingers, which suggests a strain or sprain of the muscles or ligaments in the shoulder and arm.
Other Likely Diagnoses
- Thoracic Outlet Syndrome: This condition involves compression of the nerves and/or blood vessels that pass through the thoracic outlet (the space between the collarbone and first rib), which can cause pain and numbness in the shoulder, arm, and hand.
- Cervical Radiculopathy: This refers to nerve root irritation or compression in the cervical spine, which can cause pain, numbness, and tingling in the shoulder, arm, and hand.
- Rotator Cuff Tendinitis: Inflammation of the tendons that surround the shoulder joint can cause pain and stiffness in the shoulder, which may radiate down the arm.
Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although less likely, it is crucial to consider cardiac causes of arm pain, especially if accompanied by chest pain, shortness of breath, or other cardiac symptoms.
- Pulmonary Embolism: Sudden onset of shoulder pain can be a symptom of a pulmonary embolism, especially if accompanied by shortness of breath, chest pain, or cough.
- Spinal Cord Injury or Compression: Trauma or other conditions that affect the spinal cord can cause numbness, tingling, and pain in the arm, and it is essential to rule out these potentially serious conditions.
Rare Diagnoses
- Pancoast Tumor: A rare type of lung cancer that can cause shoulder pain due to compression of the nerves and blood vessels that pass through the thoracic outlet.
- Brachial Plexitis (Neuralgic Amyotrophy): An inflammatory condition that affects the brachial plexus, causing severe pain, weakness, and atrophy of the muscles in the shoulder and arm.
- Complex Regional Pain Syndrome: A chronic pain condition characterized by severe, burning pain in the arm, often following an injury or trauma.