Differential Diagnosis for Possible Rotator Cuff Injury or Abnormality
Single Most Likely Diagnosis
- Rotator Cuff Tendinopathy: This is the most common cause of shoulder pain and dysfunction, often resulting from overuse, repetitive strain, or acute injury. The rotator cuff tendons (supraspinatus, infraspinatus, teres minor, and subscapularis) can become inflamed or torn, leading to pain, weakness, and limited mobility.
Other Likely Diagnoses
- Rotator Cuff Tear: A tear in one or more of the rotator cuff tendons can cause significant pain, weakness, and loss of function. Tears can be partial or full thickness and may require surgical intervention.
- Subacromial Bursitis: Inflammation of the subacromial bursa, which reduces friction between the rotator cuff tendons and the acromion, can cause pain and limited mobility.
- Adhesive Capsulitis (Frozen Shoulder): Characterized by stiffness, pain, and limited range of motion, adhesive capsulitis can be primary (idiopathic) or secondary, following trauma or immobilization.
- Labral Tear: A tear in the glenoid labrum, the cartilaginous structure surrounding the socket of the shoulder joint, can cause pain, especially with movement.
Do Not Miss Diagnoses
- Proximal Humerus Fracture: A fracture of the upper arm bone near the shoulder joint can mimic rotator cuff symptoms but requires prompt recognition and treatment to avoid complications.
- Glenohumeral Arthritis: Arthritis of the shoulder joint can cause pain, stiffness, and limited mobility, and while less common than rotator cuff issues, it's crucial for long-term management and potential surgical intervention.
- Thoracic Outlet Syndrome: Compression of the nerves and/or blood vessels between the neck and shoulder can cause pain, numbness, and weakness in the arm, which might be mistaken for rotator cuff pathology.
Rare Diagnoses
- Quadrilateral Space Syndrome: Compression of the axillary nerve and posterior circumflex humeral artery can cause pain and weakness, particularly with abduction and external rotation.
- Suprascapular Neuropathy: Compression or injury to the suprascapular nerve can lead to weakness of the supraspinatus and infraspinatus muscles, mimicking rotator cuff tears.
- Osteonecrosis of the Humeral Head: Avascular necrosis of the bone at the top of the humerus can cause shoulder pain and limited mobility, often without a clear history of trauma.