Differential Diagnosis for Shoulder Pain with Elevated CRP and Sed Rate
Single Most Likely Diagnosis
- Polymyalgia Rheumatica (PMR): This condition is characterized by shoulder pain, elevated inflammatory markers (CRP and sed rate), and morning stiffness. The patient's age and the presence of systemic inflammation support this diagnosis.
Other Likely Diagnoses
- Rheumatoid Arthritis (RA): Although RA typically affects the hands and feet, it can also cause shoulder pain. The elevated CRP and sed rate are consistent with an inflammatory arthritis like RA.
- Septic Arthritis: This is an infection within a joint, which can cause pain, swelling, and elevated inflammatory markers. Although less likely, it is essential to consider this diagnosis, especially if the patient has a history of joint problems or recent trauma.
- Giant Cell Arteritis (GCA): This condition is closely related to PMR and can cause shoulder pain, headache, and visual disturbances. The elevated CRP and sed rate support this diagnosis.
Do Not Miss Diagnoses
- Infectious Endocarditis: This is a bacterial infection of the heart valves, which can cause systemic inflammation, joint pain, and elevated CRP and sed rate. Although less likely, missing this diagnosis can be fatal.
- Malignancy (e.g., Multiple Myeloma): Some cancers, such as multiple myeloma, can cause bone pain, elevated inflammatory markers, and systemic symptoms. It is essential to consider this diagnosis, especially if the patient has a history of cancer or unexplained weight loss.
- Osteomyelitis: This is an infection of the bone, which can cause pain, swelling, and elevated inflammatory markers. Although less likely, it is crucial to consider this diagnosis, especially if the patient has a history of trauma or recent surgery.
Rare Diagnoses
- Relapsing Polychondritis: This is a rare autoimmune disorder that causes inflammation of cartilage and connective tissue, leading to joint pain, swelling, and elevated inflammatory markers.
- Sarcoidosis: This is a rare condition that causes inflammation in various parts of the body, including the joints, lungs, and skin. It can cause shoulder pain, elevated CRP and sed rate, and systemic symptoms.