Differential Diagnosis for Shoulder Pain
Single Most Likely Diagnosis
- Rotator Cuff Tendinitis: This is the most common cause of shoulder pain, often resulting from overuse or repetitive strain on the rotator cuff muscles and tendons. It typically presents with pain in the shoulder and upper arm, especially with movements involving lifting or rotation.
Other Likely Diagnoses
- Adhesive Capsulitis (Frozen Shoulder): Characterized by stiffness and pain in the shoulder joint, adhesive capsulitis can follow an injury or develop without a known cause. It leads to reduced mobility of the shoulder.
- Bursitis: Inflammation of the bursae, the fluid-filled sacs that cushion the joints, can cause pain and swelling in the shoulder. It often occurs in conjunction with rotator cuff tendinitis.
- Labral Tears: Tears in the labrum, the cartilage that surrounds the socket of the shoulder joint, can cause pain and instability in the shoulder. These tears can result from acute injuries or chronic wear and tear.
Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although less common, shoulder pain can be a referred pain from a myocardial infarction, especially if the pain is radiating to the left arm or is accompanied by other symptoms like chest pain, shortness of breath, or nausea.
- Pulmonary Embolism: In rare cases, shoulder pain can be a symptom of a pulmonary embolism, particularly if it is accompanied by shortness of breath, chest pain, or cough.
- Thoracic Outlet Syndrome: Compression of the nerves or blood vessels between the collarbone and first rib can cause shoulder and arm pain, numbness, and weakness.
Rare Diagnoses
- Osteonecrosis (Avascular Necrosis) of the Humeral Head: A condition where the blood supply to the bone tissue is interrupted, leading to bone death. It can cause severe shoulder pain and is more common in individuals with risk factors such as long-term steroid use or excessive alcohol consumption.
- Tumors: Both benign and malignant tumors can cause shoulder pain, although they are rare causes. Examples include osteoid osteoma, osteosarcoma, or metastatic disease to the shoulder region.
- Infections: Septic arthritis or osteomyelitis of the shoulder joint or surrounding bones can cause severe pain, swelling, and redness, often accompanied by systemic symptoms like fever.