What is the diagnosis for a patient with full passive range of motion (ROM), limited active range of motion, pain in the right shoulder, and paresthesia (abnormal sensation) to the bicep?

Differential Diagnosis for Shoulder Pain and Paresthesia

Single Most Likely Diagnosis

• Adhesive Capsulitis (Frozen Shoulder): This condition is characterized by limited active range of motion (ROM) with full passive ROM, which matches the patient's presentation. Pain and stiffness in the shoulder, along with paresthesia, can occur due to inflammation and scarring of the shoulder joint.

Other Likely Diagnoses

• Rotator Cuff Tendinopathy or Tear: This condition can cause pain and limited active ROM due to inflammation or tearing of the tendons surrounding the shoulder joint. Paresthesia can occur if the injury affects nearby nerves.
• Subacromial Bursitis: Inflammation of the bursa under the acromion can cause shoulder pain and limited active ROM. Paresthesia may be present if the bursitis affects nearby nerves.
• Thoracic Outlet Syndrome: Compression of the nerves and blood vessels between the neck and shoulder can cause pain, limited ROM, and paresthesia in the shoulder and arm.

Do Not Miss Diagnoses

• Brachial Plexus Injury: A serious injury to the nerves of the brachial plexus can cause severe pain, limited ROM, and paresthesia. Missing this diagnosis can lead to permanent nerve damage.
• Cervical Radiculopathy: Compression of the nerves in the cervical spine can cause pain, limited ROM, and paresthesia in the shoulder and arm. Missing this diagnosis can lead to chronic pain and disability.
• Shoulder Dislocation or Fracture: A traumatic injury to the shoulder can cause severe pain, limited ROM, and paresthesia. Missing this diagnosis can lead to further injury and complications.

Rare Diagnoses

• Pancoast Tumor: A rare type of lung cancer that can cause shoulder pain, limited ROM, and paresthesia due to compression of nearby nerves and structures.
• Sickle Cell Crisis: A rare condition that can cause severe pain and limited ROM in the shoulder due to sickling of red blood cells.
• Osteonecrosis of the Humeral Head: A rare condition that can cause shoulder pain and limited ROM due to death of the bone tissue in the humeral head.