Differential Diagnosis for Dorsal Hand Pain with Flexion of Middle and 4th Fingers
- Single most likely diagnosis:
- Dupuytren's Contracture: A condition characterized by the thickening of the palmar fascia, leading to flexion deformity of the fingers, commonly affecting the 4th and 5th fingers, but can also involve the middle finger. The dorsal hand pain could be referred or associated with the contracture.
- Other Likely diagnoses:
- Trigger Finger: A condition where the tendon sheath becomes inflamed, causing pain and stiffness, especially when flexing the fingers. It could lead to dorsal hand pain due to the inflammatory process.
- Ganglion Cyst: A benign lump that can develop on the wrist or hand, sometimes causing pain, especially if it presses on a nerve. Flexion of the fingers could exacerbate the pain.
- Tendinitis or Tenosynovitis: Inflammation of the tendons or their surrounding sheaths can cause pain and stiffness in the hand, particularly with movement.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Compartment Syndrome: A serious condition resulting from increased pressure within a muscle compartment, which can lead to nerve and muscle damage. Although less common, it's crucial to consider due to its potential severity.
- Infections (e.g., Abscess or Cellulitis): Infections in the hand can cause significant pain and swelling. Early diagnosis and treatment are essential to prevent serious complications.
- Rare diagnoses:
- Kienböck's Disease: A rare condition involving the collapse of the lunate bone in the wrist, which can cause wrist and hand pain, but it's less directly associated with the specific flexion deformity of the middle and 4th fingers.
- Camptodactyly: A rare congenital condition that causes one or more fingers to be permanently bent, but it typically presents at birth or in early childhood.