Differential Diagnosis for Shoulder Pain
Single Most Likely Diagnosis
- Rotator Cuff Tendinitis: This is the most common cause of shoulder pain, often resulting from overuse or repetitive strain on the rotator cuff muscles and tendons. It typically presents with pain in the shoulder and upper arm, especially with movements involving lifting or rotation.
Other Likely Diagnoses
- Adhesive Capsulitis (Frozen Shoulder): Characterized by stiffness and pain in the shoulder joint, adhesive capsulitis can follow an injury or develop without a known cause. It leads to reduced mobility of the shoulder.
- Subacromial Bursitis: Inflammation of the bursa that cushions the rotator cuff tendons, often due to repetitive motion or direct trauma, causing pain and swelling in the shoulder.
- Shoulder Impingement Syndrome: Occurs when the tendons of the rotator cuff are compressed as they pass under the acromion, leading to pain and limited movement, especially with overhead activities.
- Labral Tears: Tears in the cartilage that surrounds the socket of the shoulder joint, which can cause pain, especially with movements that involve throwing or lifting.
Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although less common, shoulder pain can be a referred pain from a myocardial infarction, especially if the pain is radiating to the left arm or is accompanied by other symptoms like chest pain or shortness of breath.
- Pulmonary Embolism: Can cause referred pain to the shoulder, especially if the embolism involves the upper parts of the lung. Accompanying symptoms might include sudden onset of shortness of breath or chest pain.
- Gallbladder Disease: Referred pain from gallbladder inflammation or stones can sometimes be felt in the right shoulder, often accompanied by abdominal pain, nausea, or fever.
- Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain that radiates to the back and sometimes the shoulders.
Rare Diagnoses
- Osteonecrosis of the Humeral Head: A condition where the blood supply to the bone tissue at the head of the humerus is interrupted, leading to bone death and potentially causing shoulder pain.
- Tumors (Bone or Soft Tissue): Although rare, tumors in the shoulder region can cause pain, swelling, or limited mobility.
- Infections (Septic Arthritis or Osteomyelitis): Infections within the shoulder joint or bone can cause severe pain, swelling, and fever, and are medical emergencies.
- Thoracic Outlet Syndrome: Compression of the nerves or blood vessels that pass through the thoracic outlet can cause shoulder and arm pain, numbness, or weakness.