Table 1 The differential diagnosis of Parsonage-Turner syndrome, based on Van Alfen et al.[2]
From: Parsonage-Turner syndrome following post-exposure prophylaxis
Orthopaedic disorders | Distinguishing features |
|---|---|
Rotator cuff pathology | Subacute or insidious onset, pain intensity varies, worsens with motion, weakness, progressive |
Adhesive capsulitis | Subacute onset, pain, ‘frozen shoulder’, limited range of motion (active and passive), progressive |
Subacromial bursitis | Subacute onset, pain along front and side, nighttime pain, painful arc of motion, fluctuating course |
Calcific tendinitis | Subacute onset, pain, worsens with elevation, sometimes stiffness, self-limiting |
Osteoarthritis | Insidious onset, pain, worsens with motion, stiffness, secondary weakness, slowly progressive |
Facioscapulohumeral dystrophy | Onset during adolescence, facial weakness, weakening biceps/triceps/deltoids, hearing loss, painless, progressive |
Cervical spondylosis with referred brachialgia | Often posture or activity dependent, no neurological deficits, fluctuating course |
(Primary) tumors of the scapula | Non acute onset, scapular winging without weakness and no neurological symptoms |
Neurological disorders | Distinguishing features |
Cervical radiculopathy, degenerative | Insidious onset, slowly progressive or fluctuating course |
Cervical radiculopathy, discrupture | Acute onset, pain varies with posture: pain, sensory and motor symptoms occur in the same dermatome |
Mononeuritis multiplex/vasculitis | Symptoms also occur in legs or distal arm, subacute onset, progressive |
Multifocal motor neuropathy | Painless, no sensory symptoms, distal predominance, progressive |
Asian tick-borne encephalitis (poliomyelitic) | Following viral prodrome, severe headache and back pain, flaccid shoulder girdle paralysis |
Focal motor neuron disease | Insidious onset, no sensory symptoms, painless, progressive |
Entrapment neuropathies | Subacute onset, mild to moderate pain, prominent sensory symptoms |
Other disorders | Distinguishing features |
Complex regional pain syndrome | Subacute onset, vasomotor features predominate, diffuse pain and weakness, progressive |
Lyme disease | Subacute onset, swelling, pain, rash, fever, fatigue, fluctuating course |