What is the cause of clicking in the shoulder, also known as crepitus (creaking or grating sensation)?

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Differential Diagnosis for Clicking in Shoulder

  • Single most likely diagnosis
    • Snapping Scapula Syndrome: This condition is characterized by a clicking or snapping sound in the shoulder due to the scapula rubbing against the rib cage. It's a common cause of shoulder clicking and is often related to scapular dyskinesis or thoracic spine abnormalities.
  • Other Likely diagnoses
    • Subluxation of the Long Head of the Biceps Tendon: This occurs when the tendon of the long head of the biceps muscle slips out of its groove, causing a clicking sound. It's often associated with shoulder instability or rotator cuff tears.
    • Labral Tears: Tears in the labrum, a cartilaginous structure surrounding the socket of the shoulder joint, can cause clicking or snapping sounds, especially with movement of the arm.
    • Adhesive Capsulitis (Frozen Shoulder): Although more commonly associated with stiffness and limited range of motion, some patients with frozen shoulder may experience clicking or snapping sounds due to the contraction of the joint capsule.
  • Do Not Miss diagnoses
    • Osteonecrosis of the Humeral Head: A condition where the blood supply to the humeral head is disrupted, leading to bone death. It can cause clicking or grinding sounds due to the collapse of the bone, and missing this diagnosis can lead to severe and irreversible damage.
    • Septic Arthritis: An infection within the shoulder joint, which can cause clicking or grinding sounds due to the destruction of the joint surfaces. This is a medical emergency requiring prompt treatment to prevent long-term damage.
  • Rare diagnoses
    • Synovial Chondromatosis: A rare condition where cartilaginous nodules form within the synovial membrane of the joint, causing clicking or locking sensations.
    • Intra-Articular Loose Bodies: Rarely, loose fragments of bone or cartilage can become trapped within the shoulder joint, causing clicking or snapping sounds with movement.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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