Differential Diagnosis for Shoulder Pain
The differential diagnosis for shoulder pain can be organized into the following categories:
- Single Most Likely Diagnosis
- Rotator cuff tendinitis: This is the most common cause of shoulder pain, often resulting from repetitive strain or acute injury to the rotator cuff muscles and tendons.
- Other Likely Diagnoses
- Adhesive capsulitis (frozen shoulder): Characterized by stiffness and limited range of motion in the shoulder, often following trauma or inflammation.
- Bursitis: Inflammation of the bursae, fluid-filled sacs that cushion joints and reduce friction, can cause pain and swelling in the shoulder.
- Osteoarthritis: Wear and tear on the joint cartilage can lead to pain, stiffness, and limited mobility in the shoulder.
- Labral tears: Tears in the labrum, a cartilage ring surrounding the socket of the shoulder joint, can cause pain and instability.
- Do Not Miss Diagnoses
- Septic arthritis: Bacterial infection within the joint can lead to severe pain, swelling, and potential joint destruction if not promptly treated.
- Fractures: Broken bones in the shoulder region, such as the clavicle, humerus, or scapula, require immediate medical attention.
- Axillary artery aneurysm or thoracic outlet syndrome: Compression or damage to the blood vessels or nerves in the thoracic outlet can cause severe pain, numbness, and potentially life-threatening complications.
- Pancoast tumor: A type of lung cancer that can cause shoulder pain due to invasion of the brachial plexus or nearby structures.
- Rare Diagnoses
- Rheumatoid arthritis: An autoimmune disorder that can cause inflammation and pain in the shoulder joints, although it is less common than other forms of arthritis.
- Polymyalgia rheumatica: An inflammatory condition that affects the muscles and joints, often causing pain and stiffness in the shoulders and hips.
- Osteonecrosis: Death of bone tissue due to lack of blood supply, which can occur in the shoulder joint and cause pain and limited mobility.
- Sickle cell disease: A genetic disorder that can cause bone pain, including in the shoulders, due to vaso-occlusive crises.