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 is characterized by pain and stiffness in the shoulder, especially with movement.
Other Likely Diagnoses
- Adhesive Capsulitis (Frozen Shoulder): Characterized by stiffness and pain in the shoulder joint, adhesive capsulitis can significantly limit the range of motion. It often develops after a period of immobility or injury.
- Bursitis: Inflammation of the bursae, the fluid-filled sacs that cushion the joints, can cause pain and swelling in the shoulder. It is commonly associated with repetitive motion or direct trauma to the shoulder.
- 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 injury or chronic wear and tear.
Do Not Miss Diagnoses
- Fracture: While less common, fractures of the shoulder (such as the clavicle, humerus, or scapula) can cause severe pain and require immediate medical attention. Missing a fracture could lead to improper healing and long-term disability.
- Dislocation: A dislocated shoulder, where the humerus comes out of the shoulder socket, is a medical emergency. It requires prompt reduction to avoid nerve and vascular damage.
- Infection (Septic Arthritis): Infection within the shoulder joint can cause severe pain, swelling, and fever. It is a medical emergency that requires immediate antibiotic treatment and possibly surgical intervention to prevent joint destruction.
Rare Diagnoses
- Tumors: Both benign and malignant tumors can occur in the shoulder region, causing pain and other symptoms. While rare, they are important to consider in the differential diagnosis, especially in cases where pain persists or worsens over time without a clear cause.
- Referred Pain from the Cervical Spine: Sometimes, pain from the cervical spine can radiate to the shoulder, mimicking shoulder pathology. Conditions such as cervical disc disease or cervical spondylosis can cause this type of referred pain.
- Polymyalgia Rheumatica: This inflammatory condition causes muscle pain and stiffness, often affecting the shoulders. It is more common in older adults and can be associated with giant cell arteritis, making it a critical diagnosis not to miss.