Differential Diagnosis for 44-year-old Female with Bilateral Shoulder Pain
Single Most Likely Diagnosis
- Polymyalgia Rheumatica (PMR): This condition is characterized by aching and stiffness in the shoulders, neck, and hips, which matches the patient's symptoms. The slightly elevated CRP and CK levels also support this diagnosis, as PMR is an inflammatory condition.
Other Likely Diagnoses
- Adhesive Capsulitis (Frozen Shoulder): Although this condition typically affects one shoulder, it can occasionally be bilateral. The reduced range of motion and pain in the shoulders are consistent with adhesive capsulitis.
- Rheumatoid Arthritis (RA): RA can cause bilateral shoulder pain, reduced range of motion, and parasthesia. The elevated CRP and CK levels also support this diagnosis, as RA is an inflammatory condition.
- Rotator Cuff Tendinitis: This condition can cause shoulder pain and reduced range of motion, but it is less likely to cause bilateral symptoms and parasthesia.
Do Not Miss Diagnoses
- Giant Cell Arteritis: Although less likely, this condition can cause shoulder pain and elevated inflammatory markers. If missed, it can lead to serious complications such as vision loss.
- Neoplastic or Paraneoplastic Syndrome: In rare cases, shoulder pain and parasthesia can be symptoms of an underlying neoplasm. It is essential to consider this possibility to avoid missing a potentially life-threatening condition.
- Infectious or Septic Arthritis: Although the patient's symptoms do not strongly suggest an infectious cause, it is crucial to consider this possibility to avoid missing a potentially life-threatening condition.
Rare Diagnoses
- Dermatomyositis: This is an inflammatory muscle disease that can cause shoulder pain, weakness, and parasthesia. However, it is a rare condition and would require further evaluation to confirm.
- Brachial Plexitis (Neuralgic Amyotrophy): This condition can cause shoulder pain, parasthesia, and weakness, but it is relatively rare and would require further evaluation to confirm.
- Sjögren's Syndrome: This autoimmune disorder can cause musculoskeletal symptoms, including shoulder pain, but it is relatively rare and would require further evaluation to confirm.