Differential Diagnosis for Hip and Shoulder Girdle Pain

Single Most Likely Diagnosis

• Polymyalgia Rheumatica (PMR): This condition is characterized by aching and stiffness in the shoulder and hip girdle areas, which matches the patient's symptoms. It is a common condition in older adults and often responds well to corticosteroid treatment.

Other Likely Diagnoses

• Osteoarthritis: This is a common condition that can cause pain in the hips and shoulders due to wear and tear of the joints. The pain is typically worse with activity and better with rest.
• Fibromyalgia: A chronic condition characterized by widespread musculoskeletal pain, including the hip and shoulder girdle areas, often accompanied by fatigue and sleep disturbances.
• Rotator Cuff Tendinitis/Bursitis: Inflammation of the tendons or bursae in the shoulder can cause pain in the shoulder girdle area, which may radiate to the hip due to referred pain.
• Trochanteric Bursitis: Inflammation of the bursa over the greater trochanter of the femur can cause hip pain, which may be referred to the shoulder girdle area.

Do Not Miss Diagnoses

• Septic Arthritis: A bacterial infection within a joint, which can cause severe pain, swelling, and redness. If not promptly treated, it can lead to joint destruction and systemic infection.
• Avascular Necrosis: A condition where the blood supply to the bone is interrupted, leading to bone death. It can cause severe hip pain and, if not treated, can lead to collapse of the bone.
• Metastatic Bone Disease: Cancer that has spread to the bones can cause pain in the hips and shoulders. It is essential to consider this diagnosis, especially in patients with a history of cancer.
• Multiple Myeloma: A type of blood cancer that can cause bone pain, including in the hips and shoulders, due to bone lesions.

Rare Diagnoses

• Ehlers-Danlos Syndrome: A group of genetic disorders that affect the connective tissue, leading to joint hypermobility and pain, including in the hips and shoulders.
• Marfan Syndrome: A genetic disorder that affects the connective tissue, leading to joint pain and other systemic symptoms, including in the hips and shoulders.
• Sarcoidosis: A condition where inflammatory cells form lumps in various parts of the body, including the joints, which can cause pain in the hips and shoulders.
• Relapsing Polychondritis: A rare autoimmune disorder that causes inflammation of the cartilage, leading to joint pain and other systemic symptoms, including in the hips and shoulders.