Differential Diagnosis for Dorsal Hand Pain with Flexion
- Single most likely diagnosis
- Tenosynovitis: This condition, which involves inflammation of the tendon sheath, is a common cause of dorsal hand pain, especially when exacerbated by flexion. The pain is typically localized to the affected tendon and can be accompanied by swelling and stiffness.
- Other Likely diagnoses
- De Quervain's tenosynovitis: A specific type of tenosynovitis affecting the tendons on the thumb side of the wrist, which can cause pain on the dorsal aspect of the hand, particularly with flexion and thumb movement.
- Ganglion cyst: A common, benign lump that can develop on the dorsal aspect of the wrist or hand, sometimes causing pain, especially if it compresses nearby nerves or tendons.
- Extensor tendonitis: Inflammation of the extensor tendons on the back of the hand can cause pain, especially with flexion against resistance, due to the increased tension on these tendons.
- Do Not Miss diagnoses
- Infections (e.g., cellulitis, abscess): Although less common, infections in the hand can cause significant pain and swelling and require prompt antibiotic treatment to prevent serious complications.
- Fractures or dislocations: Traumatic injuries to the bones or joints of the hand can cause pain with movement, including flexion, and must be identified to ensure proper alignment and healing.
- Nerve compression (e.g., radial nerve compression): Compression of nerves in the hand or wrist can cause pain, numbness, and weakness, and if not addressed, can lead to permanent nerve damage.
- Rare diagnoses
- Tumors (benign or malignant): Although rare, tumors can occur in the hand and cause pain, especially if they compress or invade surrounding structures.
- Rheumatologic conditions (e.g., rheumatoid arthritis): Systemic diseases that affect the joints can cause hand pain, including pain on the dorsal aspect with flexion, due to inflammation and joint destruction.
- Vascular conditions (e.g., Raynaud's phenomenon): Conditions affecting blood flow to the hand can cause pain, especially with cold exposure or stress, and may be exacerbated by certain movements.