Differential Diagnosis for Pain Radiating Down Hand to Fingers and Deltoid Region
Single Most Likely Diagnosis
- Rotator Cuff Strain or Tear: This is the most likely diagnosis given the pain in the deltoid region with lateral arm raise and the mechanism of injury (pulling down on a garage door). The action of pulling down can cause strain or tearing of the rotator cuff muscles, leading to pain and weakness in the shoulder and potentially radiating down the arm.
Other Likely Diagnoses
- Bicipital Tendinitis: Inflammation of the biceps tendon can cause pain in the shoulder and upper arm, especially with activities that involve lifting or overhead movements. The pain can radiate down to the forearm and hand.
- Thoracic Outlet Syndrome: Compression of the nerves and/or blood vessels in the thoracic outlet (the space between the collarbone and first rib) can cause pain and numbness in the shoulder, arm, and hand. Activities that involve lifting or reaching can exacerbate symptoms.
- Cervical Radiculopathy: Compression or irritation of the nerves in the cervical spine can cause pain, numbness, and weakness in the arm and hand. The pain can radiate down from the neck to the hand, depending on which nerve root is affected.
Do Not Miss Diagnoses
- Acute Coronary Syndrome: Although less likely, it's crucial to consider cardiac causes of arm pain, especially if the pain is severe, sudden, or accompanied by other symptoms like chest pain, shortness of breath, or nausea. Delayed diagnosis can be fatal.
- Stroke or Transient Ischemic Attack (TIA): Sudden onset of arm weakness or numbness, especially if accompanied by facial weakness, speech difficulties, or other neurological deficits, requires immediate medical attention to rule out a stroke or TIA.
Rare Diagnoses
- Pancoast Tumor: A rare type of lung cancer that can cause shoulder and arm pain due to compression of the brachial plexus. It's typically associated with other symptoms like weight loss and cough.
- Brachial Plexitis (Neuralgic Amyotrophy): An inflammatory condition of the brachial plexus that can cause severe pain in the shoulder and arm, followed by weakness and atrophy of the muscles. It's a rare condition and often idiopathic.