Differential Diagnosis for Lateral Shoulder Blade Muscle Pain after Exercise Injury

• Single most likely diagnosis:
  • Muscle Strain: This is the most likely cause of lateral shoulder blade muscle pain after an exercise injury. The muscles in this area, such as the trapezius, rhomboids, and levator scapulae, are prone to strain due to overuse or improper exercise technique.
• Other Likely diagnoses:
  • Scapulothoracic Bursitis: Inflammation of the bursae between the scapula and thoracic wall can cause pain in the lateral shoulder blade area, especially after repetitive movements or exercises that involve scapular rotation.
  • Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum can radiate pain to the lateral shoulder blade area, particularly if the exercise involves movements that stress the thoracic cage.
  • Thoracic Outlet Syndrome: Compression of the nerves and blood vessels that pass through the thoracic outlet can cause pain, numbness, and tingling in the shoulder and arm, including the lateral shoulder blade area.
• Do Not Miss diagnoses:
  • Pulmonary Embolism: Although rare, a pulmonary embolism can cause sudden, severe chest pain that radiates to the shoulder and arm, including the lateral shoulder blade area. This is a life-threatening condition that requires immediate medical attention.
  • Myocardial Infarction: Chest pain that radiates to the shoulder and arm can also be a symptom of a heart attack. This is another life-threatening condition that requires prompt medical evaluation.
• Rare diagnoses:
  • Tietze's Syndrome: A rare condition characterized by inflammation of the cartilage that connects the ribs to the sternum, which can cause pain in the chest and shoulder area, including the lateral shoulder blade.
  • Sickle Cell Crisis: In individuals with sickle cell disease, a crisis can cause severe pain in various parts of the body, including the shoulder and arm.
  • Osteoid Osteoma: A rare, benign bone tumor that can cause nocturnal pain in the affected area, which can include the lateral shoulder blade.