Differential Diagnosis
- Single most likely diagnosis
- Rotator Cuff Tendinopathy: This is the most likely diagnosis given the presence of full-thickness tear of the supraspinatus tendon, low-grade interstitial tear of the subscapularis tendon, and tendinosis of the supraspinatus, infraspinatus, and subscapularis tendons. The combination of these findings suggests a degenerative condition affecting the rotator cuff.
- Other Likely diagnoses
- Rotator Cuff Tear: The full-thickness tear of the supraspinatus tendon is a significant finding that could be the primary diagnosis. However, the presence of tendinosis in other tendons suggests a more widespread condition.
- Subacromial Impingement: This condition could be contributing to the tendinosis and tears, especially if there is compression of the rotator cuff tendons under the acromion.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Axillary Nerve Injury: Although not directly suggested by the findings, an axillary nerve injury could be associated with rotator cuff pathology and would have significant implications for treatment and prognosis.
- Septic Arthritis or Osteomyelitis: Infection in the shoulder joint or bone could present with similar symptoms and would require urgent treatment to prevent serious complications.
- Rare diagnoses
- Rheumatoid Arthritis: Although rare, rheumatoid arthritis could cause rotator cuff tendinosis and tears, especially if there is systemic involvement.
- Traumatic Injury: A traumatic event could have caused the full-thickness tear and low-grade interstitial tear, although the absence of muscle atrophy suggests a more chronic condition.