Differential Diagnosis for 10-month-old Boy with Shoulder Popping
- Single most likely diagnosis:
- Developmental Dysplasia of the Hip (DDH) or Shoulder Subluxation: This condition is a common cause of shoulder popping or clicking in infants, often due to ligamentous laxity or improper formation of the shoulder joint.
- Other Likely diagnoses:
- Nursemaid's Elbow (Subluxation of the Radial Head): Although more common in the elbow, a similar mechanism can cause a shoulder subluxation, leading to a popping sound.
- Shoulder Instability: Due to the natural laxity in infants' joints, shoulder instability can cause the shoulder to pop in and out of place.
- Brachial Plexus Injury: Trauma during birth can cause a brachial plexus injury, leading to weakness and possible subluxation of the shoulder joint, resulting in a popping sound.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Septic Arthritis or Osteomyelitis of the Shoulder: Infection in the shoulder joint or bone can cause pain and instability, leading to a popping sound. Although rare, missing this diagnosis can lead to severe consequences, including joint destruction and long-term disability.
- Tumor or Cyst: A rare possibility, but a tumor or cyst in the shoulder region can cause instability and a popping sound. Early detection is crucial for effective treatment.
- Rare diagnoses:
- Congenital Clavicular Pseudarthrosis: A rare condition where there is a false joint in the clavicle, which can cause a popping sound in the shoulder region.
- Shoulder Girdle Tumor (e.g., Ewing's Sarcoma): Although extremely rare in infants, a tumor in the shoulder girdle can cause a popping sound due to bone destruction and instability.