Differential Diagnosis for Swollen Shoulder due to Overactivity with Pain on Pulling
Single most likely diagnosis:
- Rotator Cuff Tendinitis: This condition is the most likely diagnosis given the symptoms of a swollen shoulder due to overactivity and pain with pulling. Rotator cuff tendinitis is a common injury that occurs when the tendons of the rotator cuff become inflamed, often due to repetitive motion or overuse, leading to pain and swelling in the shoulder.
Other Likely diagnoses:
- Bursitis: Inflammation of the bursae, the fluid-filled sacs that cushion the joints, can cause swelling and pain in the shoulder, especially with activities that involve pulling or lifting.
- Shoulder Impingement: This condition occurs when the shoulder blade puts pressure on the underlying tissues, including the rotator cuff tendons and bursae, when the arm is lifted. It can cause pain and swelling, particularly with overhead activities or pulling motions.
- Labral Tear: A tear in the labrum, the cartilage that surrounds the socket of the shoulder joint, can cause pain and swelling, especially with movements that involve pulling or lifting.
Do Not Miss diagnoses:
- Fracture: Although less likely, a fracture of the shoulder or upper arm could present with swelling and pain, especially if the fracture occurred due to a fall or direct trauma during overactivity. Missing this diagnosis could lead to improper healing and significant long-term disability.
- Infection (Septic Arthritis or Osteomyelitis): Infection within the shoulder joint (septic arthritis) or bone (osteomyelitis) is a medical emergency that requires prompt treatment. Symptoms can include pain, swelling, and decreased range of motion, making it crucial not to miss this diagnosis.
Rare diagnoses:
- Tumor: Both benign and malignant tumors can occur in the shoulder region, causing swelling and pain. Although rare, this diagnosis should be considered, especially if the swelling and pain are persistent and not clearly related to overactivity.
- Neurological Conditions: Certain neurological conditions, such as brachial plexitis (inflammation of the nerves that control the shoulder and arm), can cause shoulder pain and swelling. These conditions are less common but should be considered in the differential diagnosis if other causes are ruled out.