Pain with internal rotation of the left shoulder?

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Last updated: February 9, 2025View editorial policy

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Differential Diagnosis for Pain with Internal Rotation of Left Shoulder

  • Single most likely diagnosis
    • Adhesive Capsulitis (Frozen Shoulder): This condition is characterized by pain and stiffness in the shoulder, particularly with internal rotation. It is a common cause of shoulder pain and stiffness, especially in middle-aged individuals.
  • Other Likely diagnoses
    • Rotator Cuff Tendinitis: Inflammation of the tendons surrounding the shoulder joint can cause pain, especially with internal rotation. This condition is common in individuals who perform repetitive overhead activities.
    • Subacromial Bursitis: Inflammation of the bursa that cushions the rotator cuff tendons can cause pain with internal rotation, especially if the bursa is irritated or inflamed.
    • Labral Tear: A tear in the cartilage surrounding the socket of the shoulder joint can cause pain with internal rotation, especially if the tear is in the anterior or posterior labrum.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Axillary Artery Aneurysm or Thrombosis: Although rare, an aneurysm or thrombosis of the axillary artery can cause shoulder pain, especially with internal rotation, and can lead to serious complications if not promptly diagnosed and treated.
    • Brachial Plexus Injury: Trauma to the brachial plexus can cause shoulder pain, numbness, and weakness, especially with internal rotation. Prompt diagnosis and treatment are essential to prevent long-term damage.
  • Rare diagnoses
    • Septic Arthritis: A bacterial infection of the shoulder joint can cause severe pain, swelling, and stiffness, especially with internal rotation. Although rare, this condition requires prompt diagnosis and treatment to prevent joint destruction.
    • Pancoast Tumor: A rare type of lung cancer that invades the shoulder joint and surrounding tissues can cause shoulder pain, especially with internal rotation. Although rare, this condition requires prompt diagnosis and treatment to improve prognosis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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