Differential Diagnosis for Shoulder and Breast Pain
- Single most likely diagnosis
- Musculoskeletal strain or injury: This is the most common cause of shoulder and breast pain, often resulting from overuse, poor posture, or direct trauma to the area. The pain is typically localized and may be accompanied by limited range of motion.
- Other Likely diagnoses
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone, which can cause sharp pains in the chest and shoulder area.
- Thoracic outlet syndrome: Compression of the nerves and blood vessels between the neck and shoulder, leading to pain, numbness, and tingling in the shoulder, arm, and chest.
- Breast cysts or fibroadenomas: Benign breast tumors that can cause localized pain and tenderness.
- Gallbladder disease: Gallstones or inflammation of the gallbladder can cause referred pain to the right shoulder and breast area.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Myocardial infarction (heart attack): Although less common, cardiac-related pain can radiate to the shoulder and breast area, especially in women. It is crucial to consider this diagnosis, especially if accompanied by other symptoms like shortness of breath or arm pain.
- Pulmonary embolism: A blood clot in the lungs can cause sudden, severe chest pain that may radiate to the shoulder and breast area.
- Pneumothorax: A collapsed lung can cause sharp chest pain and shortness of breath, which may be referred to the shoulder and breast area.
- Rare diagnoses
- Tietze's syndrome: A rare inflammatory condition that affects the cartilage of the ribs, causing chest and shoulder pain.
- Sickle cell disease: A genetic disorder that can cause episodes of severe pain, including in the shoulder and breast area, due to sickling of red blood cells.
- Pancoast tumor: A rare type of lung cancer that can cause shoulder and breast pain due to invasion of the brachial plexus.