Differential Diagnosis for Neck, Rhomboid, and Shoulder Pain with Arm and Finger Numbness
- Single Most Likely Diagnosis
- Cervical Radiculopathy: This condition involves nerve root compression in the cervical spine, which can cause pain in the neck, shoulders, and rhomboid area. The symptoms of numbness in specific fingers (thumb, pointer, and middle finger when extending the arm, and ring and pinky fingers when bending the elbow) are consistent with compression of specific cervical nerve roots (C6 and C7). The stretching sensation of a nerve in the arm when extending it further supports this diagnosis.
- Other Likely Diagnoses
- Thoracic Outlet Syndrome (TOS): This condition involves compression of the nerves and/or blood vessels that pass through the thoracic outlet (the space between the collarbone and first rib). It can cause pain in the neck, shoulders, and arm, as well as numbness in the fingers, especially with certain movements like extending or bending the arm.
- Rotator Cuff Tendinitis or Strain: While primarily causing shoulder pain, severe rotator cuff issues can refer pain to the neck and rhomboid area. However, the specific pattern of numbness described is less typical for this condition.
- Do Not Miss Diagnoses
- Cervical Spinal Stenosis: A narrowing of the spinal canal in the neck, which can compress the spinal cord or nerve roots, leading to pain, numbness, and weakness in the arms and legs. It's a serious condition that can lead to significant disability if not addressed.
- Pancoast Tumor: A type of lung cancer located at the top of the lung that can invade nearby structures, including nerves, causing shoulder and arm pain, as well as numbness. Although rare, it's a critical diagnosis not to miss due to its severe implications.
- Rare Diagnoses
- Brachial Plexitis (Neuralgic Amyotrophy): An inflammatory condition affecting the brachial plexus, leading to severe pain in the shoulder and arm, followed by weakness and atrophy of the muscles. Numbness can occur but is less common.
- Multiple Sclerosis or Other Demyelinating Diseases: Although less likely, these conditions can present with a wide range of neurological symptoms, including numbness and pain, due to lesions in the central nervous system. The specific pattern of symptoms would be unusual but not impossible for these conditions.