Differential Diagnosis for Shoulder Pain
Single Most Likely Diagnosis
- Subacromial Bursitis/Tendinitis: This is the most common cause of shoulder pain in adults, often resulting from repetitive strain or minor trauma. It is likely in this case due to the duration of symptoms (2 months) and the age of the patient (46 years), which is consistent with the demographic commonly affected by this condition.
Other Likely Diagnoses
- Adhesive Capsulitis (Frozen Shoulder): This condition is characterized by stiffness and pain in the shoulder joint, often developing gradually over weeks to months. It is a common cause of shoulder pain in middle-aged adults.
- Rotator Cuff Strain: A strain of the rotator cuff muscles or tendons can cause shoulder pain, especially with movement. This diagnosis is likely in individuals who have recently increased their physical activity or have a history of heavy lifting.
- Osteoarthritis of the Shoulder: Although less common than in other joints like the hips or knees, osteoarthritis can affect the shoulder, causing pain and stiffness, particularly in older adults or those with a history of trauma to the shoulder.
Do Not Miss Diagnoses
- Cervical Radiculopathy: Pain referred from the cervical spine (neck) can sometimes be perceived as shoulder pain. It is crucial to identify this condition as it may require different management strategies, including addressing the cervical spine.
- Thoracic Outlet Syndrome: 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), which can cause shoulder pain among other symptoms.
- Infection (Septic Arthritis): Although rare, infection within the shoulder joint is a medical emergency that requires prompt diagnosis and treatment to prevent serious complications.
- Tumor: Both benign and malignant tumors can cause shoulder pain, and while rare, they must be considered to ensure timely diagnosis and treatment.
Rare Diagnoses
- Polymyalgia Rheumatica: An inflammatory condition that causes muscle pain and stiffness, particularly in the shoulders, but it is less common and usually presents with systemic symptoms such as fever and weight loss.
- Avascular Necrosis of the Humbar Head: A condition where the blood supply to the head of the humerus (upper arm bone) is interrupted, leading to necrosis of the bone. It is rare and often associated with specific risk factors such as long-term steroid use or excessive alcohol consumption.
- Bruck's Syndrome: A rare condition characterized by a combination of contractures of the shoulder, elbow, and other joints, often associated with other systemic features.