Differential Diagnosis for Shoulder Pain
Single Most Likely Diagnosis
- Rotator Cuff Strain or Tear: This is the most likely diagnosis given the mechanism of injury (rolling on the shoulder) and the symptoms described (inability to lift or rotate the arm due to pain). The rotator cuff is a common area for injury, especially with direct trauma or falls onto the shoulder.
Other Likely Diagnoses
- Acromioclavicular (AC) Joint Sprain: The AC joint can be injured in falls onto the shoulder, leading to pain and limited mobility of the arm. The presentation can be similar to rotator cuff injuries, making it a plausible alternative.
- Shoulder Dislocation: Although less common, a dislocation could occur from a fall onto the shoulder, causing significant pain and limitation in arm movement. The history of trauma and the inability to move the arm suggest this as a possible diagnosis.
- Bursitis: Inflammation of the bursae around the shoulder joint can cause pain and limited mobility, especially if the bursitis is acute and related to the trauma.
Do Not Miss Diagnoses
- Fracture of the Clavicle or Proximal Humerus: While less likely than soft tissue injuries, fractures in this area can occur from falls onto the shoulder and are critical to diagnose due to the potential for complications and the need for specific management, including possible surgical intervention.
- Axillary Nerve Injury: Damage to the axillary nerve can occur with shoulder dislocations or fractures and can lead to significant long-term disability if not recognized and managed appropriately.
- Vascular Injury: Although rare, injuries to the subclavian or axillary arteries can occur with severe trauma to the shoulder region and are medical emergencies.
Rare Diagnoses
- Osteonecrosis of the Humeral Head: This condition can occur after a traumatic event but is less common and typically presents with more chronic symptoms.
- Tumor: A tumor in the shoulder region could cause pain and limited mobility but would be an uncommon cause of acute symptoms following trauma.
- Infection (Septic Arthritis or Osteomyelitis): Infection in the shoulder joint or bone is a rare but serious condition that could present with pain and limited mobility, especially if there is a history of trauma or predisposing factors.