Differential Diagnosis for Left Shoulder Pain with Numbness and Tingling to Left Arm and Limited ROM to Hand

• Single Most Likely Diagnosis
  • Cervical Radiculopathy: This condition is characterized by compression or irritation of the nerve roots in the cervical spine, leading to pain, numbness, and tingling in the arm. The limited range of motion (ROM) to the hand could be due to pain or neurological deficits affecting the muscles of the arm and hand.
• Other Likely Diagnoses
  • Rotator Cuff Tendinitis or Tear: Inflammation or tears in the rotator cuff tendons can cause shoulder pain and limited mobility, which might radiate to the arm, especially if there is associated bursitis or if the tear affects the supraspinatus tendon, which could indirectly cause numbness and tingling due to altered biomechanics.
  • Thoracic Outlet Syndrome (TOS): This condition involves compression of the nerves and/or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib), leading to pain in your shoulders and neck and numbness in your fingers.
  • Brachial Plexus Injury: Trauma to the brachial plexus, a network of nerves that conducts signals from the spinal cord to the shoulder, arm, and hand, can cause pain, numbness, tingling, and limited mobility in the affected arm.
• Do Not Miss Diagnoses
  • Cervical Spinal Cord Compression: Conditions such as cervical spondylosis, disc herniation, or spinal stenosis can compress the spinal cord, leading to severe neurological deficits, including numbness, tingling, and weakness in the arms and potentially affecting bladder and bowel function.
  • Vertebral Artery Dissection or Stroke: Although less common, vertebral artery dissection can lead to stroke, presenting with sudden onset of neurological symptoms including numbness, tingling, and weakness, often with a history of neck trauma or sudden movement.
• Rare Diagnoses
  • Pancoast Tumor: A type of lung cancer located at the top of the lung that can invade the brachial plexus, ribs, and vertebrae, causing shoulder and arm pain, numbness, and tingling, along with other symptoms like weight loss and cough.
  • Multiple Sclerosis: An autoimmune disease affecting the brain and spinal cord, leading to a wide range of neurological symptoms, including numbness, tingling, and weakness, which could present in the arm if the disease process affects the cervical spinal cord.
  • Peripheral Neuropathy: Conditions such as diabetes, vitamin deficiencies, or autoimmune diseases can cause peripheral neuropathy, leading to numbness, tingling, and weakness in the hands and feet, though less commonly presenting with shoulder pain and limited ROM as primary complaints.