Could this be pancoast syndrome?

[football_fan]

Hi I am a 32y/o male currently experiencing shoulder pain. I have a history of mild hypertension and mild back ache. I used to smoke about half a pack a day since I was 17. Because of my fears I took myself to the ER in Jan08, had blood work and CXR. Everything was normal. Then in Feb08 the ache and pains came back, so I requested a CT Scan. The report states "lung and plura are clear". In mid May08 I started having shoulder pain off and on. More so in the clavicle area. My PCP told me in was probably a pinched nerve. So off I went to an Orthpedic Specialist. He dx me with bicep tendonitis and sent me to PT. So I did 4+ weeks of PT with little improvement. Infact the shoulder ache became more consistent. Then in Aug I went on vacation with my family and it was at its worse. Oddly enough since I've been back its been much better. Now I don't have much in the way of pain at all. Sometimes its stiff, sometimes I feel light pain if I move my arm in the right direction. But for the most part I'm ok. The most worrisome symptom I have now is my eyelid. Remember that vacation I mentioned earlier? Well that week before my eyelid started bothering me. It feels sticky. I keep having to rub it, in order to feel better. I've stared at myself in the mirror about a billion times. Sometimes I think it looks just a little lower than the other. I've had my wife compare them too and she says they look fine to her. I'm sweating fine on both sides of my head. I've also did some test on my pupils to see if the right one was dialating normally and it was. Yet I'm stilll concerned about the possibilities I could be facing.
I have an appointment on Friday with a Neurologist. I guess my next step is a pulmonary specialist if the Neurologist has cause for concern.
I have a couple of questions
1. Are my fears valid? Meaning what are the possibilities since having both a clean cxr and ct scan that something could develop within less than 3 months that started causing my symptoms.
2. What else could this be?

[HeinrikMD]

Hi,
IF you have access to some specialist care, you could consider seeing a Rehab (other places call them Sports medicine) doctor. These specialists are very thorough and are able to isolate specific muscle groups during the examination, so if it is indeed more muscle than nerve compression, we would know.

[football_fan]

First thanks for the comforting response. I am trying to stay positive through  out all of this. Next, I haven't played football in a few years. So I don't think that would be the problem. My favorite team is doing well so far, so I haven't thrown any remote controls. However I am remodeling my house. So between carrying and hanging drywall, painting, tiling, plumbing, etc, I suppose I could have done something. Although I don't remember anything specific, I supposed I could have done something.

[HeinrikMD]

Hi,

The pain for Pancoast syndrome generally is more common along the forearm and hand (particularly the ring and pinkie fingers) rather than on the clavicle. The presence of a mass in the lung causes compression on the nerves and produces the syndrome. It is unlikely that a mass could suddenly grow to a size that would produce symptoms in a span of 3 months.
It would be best to discuss your symptoms at length with your doctor. An investigation into the specific nerve distributions where the pain is felt is a step to start with. There are some maneuvers in which an arm and neck position may favor compression of some nerves, or some blood vessels, and in so doing produce the pain symptoms.
If you are a football fan, could it be there is previous trauma?