What is the diagnosis for a 67-year-old patient with severe left shoulder pain, described as sharp and constant, with minimal relief from Tylenol (acetaminophen), Ibuprofen (ibuprofen), and Pregabalin (pregabalin), presenting with decreased range of motion (ROM) and numbness/tingling?

Differential Diagnosis for 67-year-old with Left Shoulder Pain

Single Most Likely Diagnosis

• Adhesive Capsulitis (Frozen Shoulder): This condition is characterized by severe shoulder pain and decreased range of motion (ROM), which matches the patient's symptoms. The constant, sharp pain and limited relief from common pain medications also align with frozen shoulder.

Other Likely Diagnoses

• Rotator Cuff Tendinitis or Tear: This condition can cause severe shoulder pain, decreased ROM, and numbness/tingling due to compression of nearby nerves. The patient's age and symptoms make this a plausible diagnosis.
• Osteoarthritis of the Shoulder: This condition can cause chronic shoulder pain, decreased ROM, and numbness/tingling. The patient's age and lack of relief from pain medications suggest this as a possible diagnosis.
• Cervical Radiculopathy: This condition occurs when a nerve root in the cervical spine is compressed, causing pain, numbness, and tingling in the shoulder and arm. The patient's symptoms, including numbness/tingling, could be referred from the cervical spine.

Do Not Miss Diagnoses

• Thoracic Outlet Syndrome: This condition involves compression of the brachial plexus or subclavian artery, causing severe pain, numbness, and tingling in the shoulder and arm. Although less likely, missing this diagnosis could lead to serious complications.
• Pancoast Tumor: A rare type of lung cancer that can cause shoulder pain, numbness, and tingling due to compression of nearby nerves. Although unlikely, this diagnosis is critical to rule out due to its severe implications.
• Spinal Cord Compression: Compression of the spinal cord can cause severe pain, numbness, and tingling in the shoulder and arm. This diagnosis is crucial to consider, as delayed treatment can lead to permanent neurological damage.

Rare Diagnoses

• Brachial Plexitis (Neuralgic Amyotrophy): A rare condition characterized by severe shoulder pain and numbness/tingling due to inflammation of the brachial plexus. This diagnosis is less likely but should be considered if other diagnoses are ruled out.
• Polymyalgia Rheumatica: A rare inflammatory condition that can cause severe shoulder pain and stiffness, often accompanied by systemic symptoms. Although unlikely, this diagnosis should be considered if the patient has other systemic symptoms.