Differential Diagnosis for Shoulder Pain
- Single most likely diagnosis
- Rotator Cuff Strain or Tear: The patient's history of recent physical activity (coached t-ball practice) followed by progressive shoulder pain and sudden worsening of symptoms is consistent with a rotator cuff injury. The lack of weakness or dropping things suggests that the injury may not be a full-thickness tear, but rather a strain or partial tear.
- Other Likely diagnoses
- Shoulder Impingement: The patient's symptoms of progressive shoulder pain and limited range of motion are also consistent with shoulder impingement, which can occur when the rotator cuff tendons become inflamed or irritated.
- Bursitis: Inflammation of the bursae in the shoulder joint can cause pain and limited range of motion, and can be related to recent physical activity.
- Labral Tear: A tear in the labrum, a cartilaginous structure in the shoulder joint, can cause pain and limited range of motion, especially with certain movements.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Septic Arthritis: Although less likely, septic arthritis is a serious condition that requires prompt diagnosis and treatment. The patient's sudden onset of severe pain and limited range of motion could be consistent with septic arthritis, especially if there are systemic symptoms such as fever or chills.
- Fracture: A fracture of the shoulder or upper arm could cause severe pain and limited range of motion, and would require prompt diagnosis and treatment to avoid complications.
- Rare diagnoses
- Adhesive Capsulitis (Frozen Shoulder): Although less common, adhesive capsulitis can cause progressive shoulder pain and limited range of motion, especially in patients with a history of recent trauma or immobilization.
- Osteonecrosis: Avascular necrosis of the humeral head can cause shoulder pain and limited range of motion, especially in patients with a history of trauma or certain medical conditions.