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Shoulder Pain
Aka: Shoulder Pain, Shoulder Injury
- See Also
- Rheumatologic Conditions Affecting the Shoulder
- Shoulder Anatomy
- Shoulder Exam
- Shoulder History
- Fall on Shoulder
- Fall on Outstretched Hand
- Throwing Injuries of the Shoulder
- Causes: Acute Musculoskeletal or Glenohumeral Causes of Shoulder Pain
- Fracture
- Clavicle Fracture
- Scapula Fracture
- Humeral Fracture
- Glenohumeral Conditions
- Septic Arthritis of the Shoulder must be considered in all cases of acute Shoulder Pain
- Superior Labrum Anterior to Posterior Tear (SLAP Lesion, Labral Tear)
- Shoulder Dislocation
- Non-Glenohumeral Conditions
- Diffuse Shoulder strain
- Acromioclavicular joint separation
- Sternoclavicular Dislocation
- Tear of long head of biceps
- Causes: Chronic Musculoskeletal Causes of Shoulder Pain
- Glenohumeral overuse or injury
- Shoulder Impingement Syndrome
- Rotator Cuff Tear
- Adhesive Capsulitis
- Shoulder Degenerative Joint Disease
- See Rheumatologic Conditions Affecting the Shoulder
- Acromioclavicular joint Arthritis
- Glenohumeral joint Arthritis
- Shoulder Instability
- Shoulder Subluxation
- Recurrent Anterior Shoulder Dislocation
- Recurrent Posterior Shoulder Dislocation
- Other conditions
- Biceps Tendonitis
- Causes: Neuropathic Shoulder Pain
- Shoulder-Band Syndrome
- Herpes Zoster (Shingles)
- Brachial Neuritis
- Carpal Tunnel
- Commonly causes Shoulder Pain (in addition to wrist)
- Cervical Disc Syndrome
- Causes: Abdominal Source of Referred Shoulder Pain
- Referred pain from phrenic nerve (diaphragm) radiation sites
- Cutaneous fourth cervical Nerve (top of Shoulder)
- Innervates top of Shoulder
- Supraspinous fossa
- Over acromion or clavicle
- Etiologies
- Abdominal Trauma
- Ruptured Spleen
- Liver, Pancreas or Kidney injury
- Gastric Ulcer or Duodenal Ulcer perforation
- Subphrenic abscess
- Diaphragmatic Pleurisy
- Acute Pancreatitis
- Gallstones
- Appendicitis with peritonitis
- Liver Abscess
- Fitz-Hugh-Curtis Syndrome (Perihepatic inflammation)
- Causes: Thoracic Source of Referred Shoulder Pain
- Cardiac (e.g. Pericarditis, Myocardial Infarction)
- Left arm, or Shoulder
- Neck, lower jaw, and interscapular
- Pulmonary (Carcinoma, Pneumonia, or abscess)
- Pancoast (Apical Tumor of superior sulcus lung)
- Hiatal Hernia
- Other mediastinal, aorta, esophageal causes
- Causes: Malignant Sources of Referred Shoulder Pain
- Thyroid Cancer
- Breast Cancer
- Lung Cancer
- Renal Cancer
- Hodgkin's Lymphoma
- Prostate Cancer
- Bone Metastases (Multiple Myeloma most common)
- Shoulder metastases (less common)
- Ribs, spine, and Pelvis (more common)
- XRay and bone scans have high False Negative Rate
- Paget's Disease
- Periosteal bone formation
- Results in cranial or spinal impingement
- Usually minimal or no symptoms
- Increased pain
- Think Sarcomatous degeneration