Differential Diagnosis for Wrist Pain and Swelling after a Fall
Single Most Likely Diagnosis
- Wrist Sprain: This is the most likely diagnosis given the mechanism of injury (fall) and the presence of pain and swelling in the wrist. A sprain occurs when the ligaments surrounding the wrist joint are stretched or torn, which can happen during a fall.
Other Likely Diagnoses
- Occult Fracture: Although the X-ray is negative, it's possible that a fracture may not be visible on initial imaging, especially if it's a non-displaced or hairline fracture. Further imaging or follow-up X-rays may be necessary to rule out this possibility.
- Wrist Contusion: A contusion, or bruise, can occur when the wrist is injured during a fall, causing pain and swelling.
- Tendon or Ligament Strain: Strains to the tendons or ligaments surrounding the wrist joint can also cause pain and swelling.
Do Not Miss Diagnoses
- Scaphoid Fracture: A scaphoid fracture is a specific type of wrist fracture that can be difficult to diagnose on initial X-ray. It's essential to consider this possibility, as a missed scaphoid fracture can lead to complications such as avascular necrosis.
- Compartment Syndrome: Although rare, compartment syndrome is a potentially life-threatening condition that can occur after a wrist injury. It's characterized by increased pressure within the muscle compartments, which can lead to nerve and muscle damage.
Rare Diagnoses
- Ganglion Cyst: A ganglion cyst is a non-cancerous lump that can occur on the wrist, causing pain and swelling. However, it's less likely to be related to a recent fall.
- Osteochondritis Dissecans: This is a rare condition where a piece of cartilage and bone becomes detached from the surrounding bone, causing pain and swelling in the wrist joint.