What is the differential diagnosis for sharp nerve pain in the arm with tenderness in the axillary (axilla) region?

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Differential Diagnosis for Sharp Nerve Pain in Arm with Axillary Tenderness

Single Most Likely Diagnosis

  • Axillary Neuropathy: This condition, often resulting from compression or injury to the axillary nerve, can cause sharp pain in the arm, especially in the shoulder and upper arm area, along with tenderness in the axillary region. The axillary nerve's involvement can lead to weakness in shoulder abduction and sensory changes over the deltoid region.

Other Likely Diagnoses

  • Brachial Plexus Neuropathy: Inflammation or compression of the brachial plexus can cause sharp nerve pain in the arm. The brachial plexus is a network of nerves that come from the spinal cord and travel into the arm, and its dysfunction can lead to a variety of symptoms including pain, numbness, and weakness in the arm.
  • Cervical Radiculopathy: Nerve root compression in the cervical spine can cause sharp pain that radiates into the arm, along with axillary tenderness if the compression affects the nerve roots that contribute to the axillary nerve. This condition often results from a herniated disk, bone spurs, or other degenerative changes.
  • Thoracic Outlet Syndrome: This condition involves compression, injury, or irritation of the nerves and/or blood vessels (arteries and veins) in the thoracic outlet area, which lies between your collarbone (clavicle) and first rib. It can cause pain in your shoulders and neck and numbness in your fingers.

Do Not Miss Diagnoses

  • Acute Coronary Syndrome: Although less common, sharp pain in the arm, especially if accompanied by chest pain or other symptoms like shortness of breath, could be indicative of a myocardial infarction (heart attack) or angina. The pain can radiate to the arm due to referred pain.
  • Pulmonary Embolism: In rare cases, a pulmonary embolism can cause referred pain to the arm, especially if there is associated chest pain or shortness of breath. This is a life-threatening condition that requires immediate medical attention.

Rare Diagnoses

  • Pancoast Tumor: A rare type of lung cancer that grows in the upper part of the lung and can invade nearby tissues, including nerves, leading to shoulder and arm pain, among other symptoms.
  • Neurolymphomatosis: Involvement of the peripheral nerves by lymphoma, which can cause a variety of neurological symptoms including pain, weakness, and sensory changes in the affected areas.
  • Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the nerves, leading to neuropathic pain and other neurological symptoms.

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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