Differential Diagnosis for Aching Pain under Right Collarbone Associated with Painful Shoulder
Single Most Likely Diagnosis
- Subacromial Bursitis or Rotator Cuff Tendinitis: These conditions are common causes of shoulder pain that can radiate to the area under the collarbone due to the proximity of the shoulder joint to the clavicle. The pain is often exacerbated by movement of the shoulder.
Other Likely Diagnoses
- Adhesive Capsulitis (Frozen Shoulder): Characterized by stiffness and pain in the shoulder joint, which can also cause discomfort under the collarbone.
- Cervical Radiculopathy: Refers to damage or irritation of the roots of the spinal nerves in the cervical spine, which can cause pain that radiates to the shoulder and potentially under the collarbone.
- Thoracic Outlet Syndrome: Involves compression, injury, or irritation of the nerves and/or blood vessels (arteries and veins) in the thoracic outlet area, which can lead to pain in the shoulders and under the collarbone.
Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although less common, myocardial infarction can present with atypical symptoms including pain under the collarbone, especially if the pain is associated with other symptoms like chest pain, shortness of breath, or nausea.
- Pulmonary Embolism: Can cause sudden onset of chest pain and, in some cases, pain that radiates to the shoulder or under the collarbone, especially if associated with shortness of breath or cough.
- Gallbladder Disease: Gallstones or cholecystitis can cause right upper quadrant abdominal pain that may radiate to the right shoulder or under the collarbone due to referred pain.
Rare Diagnoses
- Pancoast Tumor: A type of lung cancer located at the top of the lung that can cause shoulder pain due to local invasion of the brachial plexus and nearby structures, potentially radiating pain under the collarbone.
- Osteonecrosis of the Humeral Head: A condition where the blood supply to the bone tissue at the head of the humerus is interrupted, leading to bone death and potentially causing severe shoulder pain.
- Referred Pain from Abdominal Pathologies: Certain abdominal conditions, such as a perforated ulcer or liver disease, can cause referred pain to the shoulder or under the collarbone, although these are less common presentations.