Differential Diagnosis for Shoulder Pain with Radiation Down Arm
Single Most Likely Diagnosis
- Rotator Cuff Tendinitis or Tear: This condition is the most common cause of shoulder pain that can radiate down the arm, especially with movements involving the shoulder joint. The pain often results from inflammation or tears in the tendons of the rotator cuff muscles.
Other Likely Diagnoses
- Cervical Radiculopathy: This condition involves nerve root irritation or compression in the cervical spine, leading to pain that can radiate from the neck down into the shoulder and arm. It's a common cause of radiating arm pain.
- Adhesive Capsulitis (Frozen Shoulder): Characterized by stiffness and pain in the shoulder joint, adhesive capsulitis can cause pain that may radiate down the arm, especially with movement.
- Thoracic Outlet Syndrome: This condition involves compression of the nerves and/or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib), leading to pain in your shoulders and neck and numbness in your fingers.
Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although less common, myocardial infarction can present with referred pain to the shoulder and down the arm, especially the left arm. It's crucial to consider this diagnosis, especially in patients with risk factors for cardiovascular disease.
- Pulmonary Embolism: In rare cases, a pulmonary embolism can cause referred pain to the shoulder and arm due to irritation of the diaphragm or pleura.
- Spinal Cord Injury or Compression: Conditions such as spinal stenosis, herniated discs, or spinal fractures can compress the spinal cord, leading to severe and potentially permanent neurological deficits if not promptly addressed.
Rare Diagnoses
- Pancoast Tumor: A type of lung cancer located at the top of the lung, which can cause shoulder pain that radiates down the arm due to invasion of the brachial plexus.
- Brachial Plexitis (Neuralgic Amyotrophy): An inflammatory condition of the brachial plexus that can cause severe pain in the shoulder and arm, followed by weakness and atrophy of the muscles.
- Referred Pain from Abdominal Pathologies: Certain abdominal conditions, such as gallbladder disease or pancreatitis, can cause referred pain to the shoulder and arm due to shared nerve roots.