So a patient presents with persistent pain at the tip of his shoulder. Quite possibly, he slept on it, and you tell him that it'll go away. Spot a flaw?
There's a possibility that your patient'll come back with an acute abdomen.
The sensory innervation of the shoulder is from the supraclavicular nerves, which have their roots at C3 and C4.
Sound familiar? C3 & C4 (Along with C5) are the roots of the phrenic nerves, which are mixed nerves. There's usually nothing interesting sensory going on in the diaphragm, but in case of any nearby pathology that causes diaphragmatic irritation : stomach, gall bladder, spleen etc, the sensory impulses of irritation from the diaphragm are interpreted as pain in the shoulder because they share the same roots.
So explore the possibility of referred pain, specially if your patient presents with an inexplicable pain in an innocuous area, that's rather suspicious!
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