Case: 70F shoulder pain adn tingling sensation in the hands
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The differential diagnosis for a 70-year-old woman with shoulder pain, neck pain, and tingling sensation in the arms is broad and includes:
Cervical spondylosis: This is a common condition that occurs as a result of age-related wear and tear on the neck joints and discs. It can cause pain, stiffness, and numbness in the neck, shoulders, and arms.
Cervical radiculopathy: This is a condition in which a nerve root in the neck is compressed. It can cause pain, numbness, and weakness in the shoulder and arm that is served by that nerve root.
Rotator cuff tear: This is a tear in one of the tendons that stabilizes the shoulder joint. It can cause pain, weakness, and difficulty moving the shoulder.
Frozen shoulder: This is a condition in which the shoulder joint capsule becomes inflamed and thickened, causing pain and stiffness in the shoulder.
Thoracic outlet syndrome: This is a condition in which the nerves and blood vessels that pass from the neck to the arm are compressed. It can cause pain, numbness, and weakness in the shoulder, arm, and hand.
Referred pain from the heart or lungs: In some cases, pain in the shoulder and arm can be referred from the heart or lungs. This is known as cardiac or pulmonary referral.
Other possible causes of shoulder pain, neck pain, and tingling sensation in the arms include:
Arthritis
Tumors
Infections
Fibromyalgia
Multiple sclerosis
Lyme disease
Diabetes
Additional information
The patient's age of 70 years is relevant because some of the conditions on the differential diagnosis are more common in older adults. For example, cervical spondylosis and rotator cuff tears are both more likely to occur in people over the age of 60.
The patient's sex is also relevant, as some conditions are more common in women or men. For example, thoracic outlet syndrome is more common in women.
The patient's medical history and social history may also provide clues to the underlying cause of her symptoms. For example, a history of smoking or diabetes can increase the risk of certain conditions, such as heart disease and arthritis.