Differential Diagnosis for Right Neck Pain Radiating to Shoulder Causing Numbness to Fingers

Single Most Likely Diagnosis

• Cervical Radiculopathy: This condition, often resulting from a herniated disc or bone spur, compresses or irritates a nerve root in the cervical spine, leading to pain in the neck that radiates to the shoulder and can cause numbness in the fingers. The specific distribution of symptoms depends on which nerve root is affected.

Other Likely Diagnoses

• Cervical Spondylosis: A common age-related condition that affects the joints and discs in the neck, leading to pain and stiffness in the neck, and potentially radiating pain and numbness to the shoulder and fingers due to nerve compression.
• Thoracic Outlet Syndrome (TOS): Involves compression, injury, or irritation of the nerves and/or blood vessels (arteries and veins) in the thoracic outlet area, which lies between your collarbone (clavicle) and first rib. This can cause pain in the neck and shoulder and numbness in the fingers.
• Brachial Plexus Injury: An injury to the brachial plexus, a network of nerves that conducts signals from the spinal cord to the shoulder, arm, and hand, can cause pain, numbness, and weakness in the arm and hand.

Do Not Miss Diagnoses

• Cervical Spinal Cord Compression: Conditions such as spinal stenosis, herniated discs, or tumors can compress the spinal cord, leading to serious neurological deficits if not promptly addressed. Symptoms can include pain, numbness, and weakness in the arms and legs.
• Stroke or Transient Ischemic Attack (TIA): Although less common, pain and numbness can be symptoms of a stroke or TIA, especially if accompanied by other neurological deficits such as weakness, vision changes, or speech difficulties.
• Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including numbness, weakness, and pain.

Rare Diagnoses

• Pancoast Tumor: A type of lung cancer located at the top of the lung that can invade the brachial plexus, causing shoulder and arm pain, numbness, and weakness.
• Arterial Thoracic Outlet Syndrome: A rare form of TOS caused by compression of the subclavian artery, which can lead to arm pain, numbness, and potentially serious vascular complications.
• Cervical Discitis or Osteomyelitis: Infections of the cervical spine that can cause severe neck pain, stiffness, and neurological symptoms due to compression or destruction of spinal structures.