Differential Diagnosis for Pain on Right Arm and with Rotation of Neck
- Single most likely diagnosis
- Cervical Radiculopathy: This condition, often resulting from a herniated disk or bone spur, compresses or irritates the nerves exiting the spinal canal, leading to pain and discomfort in the arm, which can be exacerbated by neck movements such as rotation.
- Other Likely diagnoses
- Thoracic Outlet Syndrome (TOS): 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 the shoulders and neck and numbness in the fingers, often worsening with specific movements like neck rotation.
- Rotator Cuff Tendinitis: Although primarily affecting the shoulder, severe cases can refer pain down the arm, and certain movements, including those that involve the neck, can exacerbate the condition due to the interconnectedness of the shoulder and neck musculature.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cervical Spinal Cord Injury or Compression: Conditions such as spinal stenosis, herniated disks, or fractures can compress the spinal cord, leading to severe neurological deficits. Early recognition and intervention are critical to prevent permanent damage.
- Vertebral Artery Dissection: A tear in the vertebral artery can lead to a stroke. Pain in the neck and arm, especially if accompanied by neurological symptoms, warrants immediate investigation.
- Pulmonary Embolism: Although less directly related to arm pain with neck rotation, the sudden onset of arm pain, especially if accompanied by respiratory symptoms, could indicate a pulmonary embolism, which is a medical emergency.
- Rare diagnoses
- Pancoast Tumor: A type of lung cancer located at the top of the lung that can invade the brachial plexus, causing arm pain and other neurological symptoms. It's a rare condition but should be considered in the differential diagnosis, especially in smokers or those with a history of cancer.
- Brachial Plexitis (Neuralgic Amyotrophy): An inflammatory condition affecting the brachial plexus, leading to severe pain in the shoulder and arm, which can be exacerbated by movement. It's relatively rare and often self-limiting but can cause significant morbidity.