Differential Diagnosis for Shoulder Pain and Difficulty with Overhead Abduction
Single Most Likely Diagnosis
- Rotator Cuff Tendinitis or Tear: This condition is the most common cause of shoulder pain and difficulty with movements such as picking things up and overhead abduction. The rotator cuff is a group of muscles and tendons that surround the shoulder joint, and injuries to this area can lead to significant pain and functional impairment.
Other Likely Diagnoses
- Adhesive Capsulitis (Frozen Shoulder): Characterized by stiffness and pain in the shoulder joint, adhesive capsulitis can significantly limit movement and is a common cause of difficulty with overhead activities.
- Subacromial Bursitis: Inflammation of the bursa that cushions the rotator cuff tendons can cause pain and limit movement, especially with overhead activities.
- Osteoarthritis of the Shoulder: Wear and tear on the shoulder joint can lead to pain and stiffness, affecting the ability to perform overhead movements.
Do Not Miss Diagnoses
- Axillary Nerve Injury or Compression: While less common, injury or compression of the axillary nerve can cause significant shoulder dysfunction and must be considered to avoid missing a potentially treatable condition.
- Thoracic Outlet Syndrome: Compression of the nerves and/or blood vessels that pass into the thoracic outlet can cause shoulder pain and weakness, and is a critical diagnosis not to miss due to its potential for serious complications if left untreated.
- Infection or Septic Arthritis: Although rare, infection within the shoulder joint is a medical emergency that requires prompt diagnosis and treatment to prevent serious complications.
Rare Diagnoses
- Polymyalgia Rheumatica: An inflammatory condition that affects the muscles, particularly around the shoulders, and can cause significant pain and stiffness.
- Avascular Necrosis of the Humeral Head: A condition where the blood supply to the humeral head is interrupted, leading to bone death and potentially severe shoulder pain and dysfunction.
- Tumors (Benign or Malignant): While extremely rare, tumors affecting the shoulder region can cause pain and limited mobility, and must be considered in the differential diagnosis to ensure timely and appropriate treatment.