Differential Diagnosis
The patient presents with swelling of lymph nodes, pain in the left shoulder and elbow, and numbness and tingling in the wrist. Here's a differential diagnosis based on the provided symptoms:
- Single most likely diagnosis
- Rheumatoid Arthritis (RA): The patient's symptoms of intermittent, throbbing pain in the left shoulder and elbow, radiation to the wrist, and slight numbness and tingling are consistent with RA. The swelling of lymph nodes, particularly in the cervical region, can also be seen in RA due to systemic inflammation.
- Other Likely diagnoses
- Lymphoma: The swelling of lymph nodes for 3 months could indicate a lymphoproliferative disorder such as lymphoma. The associated pain and numbness could be due to compression or infiltration of nerves.
- Osteoarthritis: Although less likely given the patient's age and the presence of lymph node swelling, osteoarthritis could cause pain and stiffness in the affected joints.
- Cervical Radiculopathy: The numbness and tingling in the wrist could be due to compression of a cervical nerve root, which could also cause pain in the shoulder and elbow.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Metastatic Cancer: Although less likely, metastatic cancer to the lymph nodes or bones could cause the patient's symptoms. It is essential to rule out this possibility due to its severe implications.
- Infectious Diseases (e.g., Tuberculosis, Lyme Disease): Certain infectious diseases could cause lymph node swelling, joint pain, and numbness. These conditions require prompt diagnosis and treatment to prevent long-term consequences.
- Rare diagnoses
- Sarcoidosis: This rare autoimmune disorder could cause lymph node swelling, joint pain, and numbness due to granulomatous inflammation.
- Relapsing Polychondritis: This rare condition involves inflammation of cartilage and could cause joint pain, numbness, and lymph node swelling.
- Paraneoplastic Syndromes: Rarely, certain cancers can cause paraneoplastic syndromes, which could manifest with lymph node swelling, joint pain, and numbness.