Differential Diagnosis for a 22-year-old male with left arm discomfort
- Single most likely diagnosis
- Lateral epicondylitis (Tennis Elbow): The patient's symptoms of pain with extension and a history of twisting his arm backwards while washing his car windows suggest overuse or strain of the extensor muscles of the forearm, which is consistent with lateral epicondylitis.
- Other Likely diagnoses
- Medial epicondylitis (Golfer's Elbow): Although less likely given the symptoms with extension, medial epicondylitis could be considered if the pain is more medially located and associated with flexion.
- Radial head fracture: The mechanism of injury (twisting the arm backwards) and the popping sensation could suggest a radial head fracture, especially if there is significant pain with rotation or flexion.
- Elbow sprain: A sprain of the elbow ligaments could also be considered given the mechanism of injury and the presence of pain with movement.
- Do Not Miss diagnoses
- Fracture of the elbow (e.g., olecranon, coronoid process): Although less likely, a fracture could be present, especially if the patient has significant pain, swelling, or deformity.
- Compartment syndrome: This is a rare but serious condition that could occur after a traumatic injury, characterized by severe pain, pallor, poikilothermia, paresthesia, and pulselessness.
- Neurovascular injury: Injury to the nerves or blood vessels of the arm could occur with a traumatic event and should be considered if there are symptoms such as numbness, tingling, or weakness.
- Rare diagnoses
- Osteochondritis dissecans of the elbow: A rare condition characterized by a fragment of cartilage and bone becoming detached from the joint surface, which could cause pain and locking of the elbow.
- Elbow dislocation: Although the patient does not report a significant traumatic event, an elbow dislocation could be considered if there is significant pain, swelling, or deformity.
- Infection or osteomyelitis: Infection of the bone or joint could occur after a traumatic injury, especially if the patient has a history of immunocompromised state or recent travel.