Differential Diagnosis for Scapular Pain
- Single most likely diagnosis
- Musculoskeletal strain: This is the most common cause of scapular pain, often resulting from overuse, poor posture, or direct trauma to the scapula or surrounding muscles.
- Other Likely diagnoses
- Scapulothoracic bursitis: Inflammation of the bursae between the scapula and the thoracic wall can cause scapular pain, especially with movements involving the scapula.
- Subscapularis tendinitis: Part of the rotator cuff, inflammation or strain of the subscapularis tendon can lead to pain in the scapular region.
- Thoracic outlet syndrome: Compression of the nerves and/or blood vessels between the clavicle and first rib can cause pain in the scapula, among other symptoms.
- Do Not Miss diagnoses
- Pulmonary embolism: Although less common, pulmonary embolism can present with sudden onset scapular pain, especially if the embolism involves the upper lobes of the lungs. Missing this diagnosis can be fatal.
- Pneumothorax: A collapsed lung can cause sudden, severe scapular pain, and is a medical emergency.
- Myocardial infarction: In some cases, a heart attack can present with referred pain to the scapula, making it crucial not to miss this potentially life-threatening condition.
- Rare diagnoses
- Scapular osteochondroma: A benign tumor of the bone and cartilage, which can cause scapular pain if it presses on surrounding tissues.
- Ewing's sarcoma: A rare type of bone cancer that can affect the scapula, among other bones, and cause pain.
- Scapular stress fracture: Although more common in athletes, stress fractures of the scapula can occur and cause persistent pain in the scapular region.