- Heart attack→ pain can radiate to L shoulder & arm
- Aortic dissection→ pain to L shoulder & arm
- Pulmonary embolous→ pain can radiate to either shoulder
- Apical lung tumor
 
   
           
        
        
        
        
        
        
        
          
          
            
  
      
    
    
      
        
            - In any of these situation, neck and shoulder exam would be normal and patient should have other suggestive sx