What is the cause of shoulder pain when attempting to abducted beyond 90 degrees?

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Differential Diagnosis for Shoulder Pain when Lifting Beyond 90 Degrees

Single Most Likely Diagnosis

  • Rotator Cuff Tendinitis: This condition is the most likely cause of shoulder pain when lifting beyond 90 degrees. The rotator cuff tendons can become inflamed and irritated, leading to pain and limited mobility, especially when attempting to lift the arm above 90 degrees.

Other Likely Diagnoses

  • Rotator Cuff Tear: A tear in one of the rotator cuff tendons can cause significant pain and weakness in the shoulder, particularly when trying to lift the arm beyond 90 degrees.
  • Adhesive Capsulitis (Frozen Shoulder): Although more commonly associated with limited mobility and pain at all ranges of motion, adhesive capsulitis can cause pain when trying to lift the arm, especially if the condition is in its early stages.
  • Bursitis: Inflammation of the bursae in the shoulder can cause pain and swelling, especially when lifting the arm, as the bursae can become irritated and inflamed.

Do Not Miss Diagnoses

  • Fracture: A fracture of the humerus, scapula, or clavicle can cause severe pain when lifting the arm, and it is crucial to rule out this possibility to avoid delayed diagnosis and treatment.
  • Axillary Nerve Injury: Damage to the axillary nerve can cause pain, weakness, and numbness in the shoulder and arm, and it is essential to consider this diagnosis to prevent long-term damage.
  • Thoracic Outlet Syndrome: Compression of the nerves and blood vessels in the thoracic outlet can cause pain, numbness, and weakness in the shoulder and arm, and it is vital to recognize this condition to provide appropriate treatment.

Rare Diagnoses

  • Osteonecrosis of the Humeral Head: A rare condition where the bone tissue in the humeral head dies due to lack of blood supply, causing pain and limited mobility in the shoulder.
  • Infectious or Inflammatory Arthritis: Conditions such as septic arthritis or rheumatoid arthritis can cause shoulder pain and limited mobility, although these are less common causes of pain when lifting beyond 90 degrees.
  • Tumor: A tumor in the shoulder region, such as a bone or soft tissue tumor, can cause pain and limited mobility, although this is a rare cause of shoulder pain.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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