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 typically presents with pain in the shoulder and upper arm, 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 occurs 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.
- Shoulder Impingement Syndrome: This condition occurs when the shoulder blade puts pressure on the underlying tissues, including the rotator cuff tendons and bursae, when the arm is lifted. It leads to pain and limited mobility.
Do Not Miss Diagnoses
- Heart Attack or Angina: Referred pain from cardiac issues can sometimes be felt in the shoulder, especially on the left side. It is crucial to consider cardiac causes, especially in patients with risk factors for heart disease.
- Pulmonary Embolism: Though less common, a pulmonary embolism can cause referred pain in the shoulder due to irritation of the diaphragm or pleura. This is a medical emergency.
- Pancoast Tumor: A type of lung cancer located at the top of the lung, a Pancoast tumor can cause shoulder pain due to local invasion of the tumor into the brachial plexus or ribs.
Rare Diagnoses
- Osteonecrosis of the Humeral Head: A condition where the blood supply to the bone tissue is interrupted, leading to bone death. It can cause severe shoulder pain and is more common in individuals with certain risk factors, such as long-term steroid use.
- Polymyalgia Rheumatica: An inflammatory condition that affects the muscles, particularly around the shoulders and hips, causing stiffness and pain. It is more common in older adults.
- Septic Arthritis of the Shoulder: A bacterial infection within the shoulder joint, which is a medical emergency requiring prompt treatment to prevent joint destruction.