Differential Diagnosis for Swelling on Shoulder Post Vaginal Birth

Single Most Likely Diagnosis

• Trauma or bruising from delivery: This is the most common cause of shoulder swelling after a vaginal birth, often resulting from the physical pressure exerted during the delivery process.

Other Likely Diagnoses

• Hematoma: A collection of blood outside of blood vessels, which can occur due to trauma during delivery, leading to swelling.
• Infection: Postpartum infections can sometimes manifest as localized swelling, although this would typically be accompanied by other symptoms such as fever and redness.
• Shoulder dystocia injury: Although more commonly associated with nerve injuries, shoulder dystocia can also lead to soft tissue trauma and swelling.

Do Not Miss Diagnoses

• Pulmonary embolism: While less directly related to shoulder swelling, a pulmonary embolism can cause sudden onset of symptoms that might initially seem unrelated, including pain that could be mistaken for shoulder issues. It's crucial to consider this due to its high mortality rate if missed.
• Deep vein thrombosis (DVT): Similar to pulmonary embolism, DVT is a serious condition that could potentially cause swelling, although it's more commonly associated with the legs. However, the postpartum period increases the risk of DVT, making it a critical diagnosis not to miss.

Rare Diagnoses

• Neoplastic conditions: Rarely, a swelling could be the first presentation of a neoplastic condition, such as a soft tissue tumor.
• Autoimmune disorders: Certain autoimmune conditions could potentially cause swelling, although these would typically be part of a broader clinical picture.
• Infectious diseases: Uncommon infectious diseases could cause localized swelling, especially if the individual has been exposed to specific pathogens.