Differential Diagnosis for Scapular Region Burning Pain

• Single most likely diagnosis
  • Musculoskeletal strain: This is the most common cause of scapular region burning pain, often resulting from overuse, poor posture, or direct trauma to the muscles and ligaments surrounding the scapula.
• Other Likely diagnoses
  • Thoracic outlet syndrome: Compression of the nerves and/or blood vessels between the clavicle and first rib can cause burning pain in the scapular region, along with numbness, tingling, and weakness in the arm.
  • Scapulothoracic bursitis: Inflammation of the bursae located between the scapula and the thoracic wall can cause burning pain and stiffness in the scapular region.
  • Rhomboid strain: Strain or overuse of the rhomboid muscles, which connect the scapula to the spine, can lead to burning pain and stiffness in the scapular region.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Pulmonary embolism: Although less common, pulmonary embolism can cause sudden, severe burning pain in the scapular region, often accompanied by shortness of breath, chest pain, and cough.
  • Pneumothorax: A collapsed lung can cause sudden, severe burning pain in the scapular region, often accompanied by shortness of breath, chest pain, and decreased breath sounds.
  • Myocardial infarction: In some cases, a heart attack can cause referred pain in the scapular region, often accompanied by chest pain, shortness of breath, and arm pain.
• Rare diagnoses
  • Pancoast tumor: A rare type of lung cancer that can cause burning pain in the scapular region, often accompanied by arm weakness, numbness, and Horner's syndrome.
  • Osteoid osteoma: A rare benign bone tumor that can cause burning pain in the scapular region, often accompanied by pain at night and relief with NSAIDs.
  • Sickle cell crisis: In patients with sickle cell disease, a crisis can cause burning pain in the scapular region, often accompanied by fever, fatigue, and jaundice.