What is the diagnosis for a patient experiencing intermittent clicking and pinching sensation in the right clavicle, with episodes of being stuck in a position, and a history of right clavicle fracture with surgical reduction and stabilization, as well as a prior intramuscular hematoma within the right sternocleidomastoid (sternocleidomastoid) muscle?

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Differential Diagnosis

  • Single most likely diagnosis
    • Subclavian artery or vein compression/thoracic outlet syndrome (TOS): The patient's symptoms of intermittent clicking, pinching sensation, and feeling "stuck" in a position, particularly when bending over and standing up, are suggestive of thoracic outlet syndrome. The prior episode of a large hematoma in the neck and the history of a right clavicle fracture with surgical reduction and stabilization may have contributed to the development of TOS.
  • Other Likely diagnoses
    • Sternocleidomastoid muscle strain or tendinitis: The patient's history of an intramuscular hematoma within the right sternocleidomastoid muscle and the current symptoms of neck pain and clicking sensation in the right clavicle area could be related to a strain or tendinitis of the sternocleidomastoid muscle.
    • Clavicle nonunion or malunion: Given the patient's history of a right clavicle fracture with surgical reduction and stabilization, there is a possibility of nonunion or malunion of the clavicle, which could be causing the clicking sensation and pain.
    • Cervical spine facet joint dysfunction: The patient's symptoms of neck pain and feeling "stuck" in a position could be related to facet joint dysfunction in the cervical spine.
  • Do Not Miss diagnoses
    • Subclavian artery aneurysm or pseudoaneurysm: The patient's history of a large hematoma in the neck and the current symptoms of clicking and pinching sensation in the right clavicle area could be indicative of a subclavian artery aneurysm or pseudoaneurysm, which would be a medical emergency.
    • Pulmonary embolism (PE) or deep vein thrombosis (DVT): Although less likely, the patient's symptoms of intermittent pain and swelling could be related to a PE or DVT, which would require immediate medical attention.
  • Rare diagnoses
    • Eagle syndrome (elongated styloid process): The patient's symptoms of clicking and pinching sensation in the right clavicle area could be related to an elongated styloid process, which is a rare condition.
    • Cervical spine ligamentous instability: The patient's symptoms of neck pain and feeling "stuck" in a position could be related to ligamentous instability in the cervical spine, which is a rare condition.

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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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