Differential Diagnosis for Right Elbow Pain
The patient presents with right elbow pain, a sensation similar to hitting the elbow, and trouble picking up heavy things at work, without weakness, numbness, or tingling in the hand, wrist, arm, or fingers. Here's a categorized differential diagnosis:
- Single Most Likely Diagnosis
- Lateral Epicondylitis (Tennis Elbow): This condition is characterized by pain on the outer part of the elbow, often related to overuse of the forearm muscles and tendons. The patient's symptom of pain when picking up heavy things and the absence of neurological symptoms like numbness or tingling make this a likely diagnosis.
- Other Likely Diagnoses
- Medial Epicondylitis (Golfer's Elbow): Although less common than lateral epicondylitis, medial epicondylitis causes pain on the inner aspect of the elbow due to inflammation of the tendons that attach to the medial epicondyle. It's possible if the patient's work involves activities that strain these tendons.
- Olecranon Bursitis: Inflammation of the bursa at the back of the elbow can cause pain and swelling, especially if the patient has recently experienced a blow to the elbow or has been leaning on it, which could fit the sensation of hitting the elbow.
- Do Not Miss Diagnoses
- Radial Head Fracture: Although the patient denies recent trauma, a fracture could present with pain, especially with heavy lifting or rotation of the forearm. Missing this diagnosis could lead to improper healing and chronic issues.
- Neoplastic Processes (e.g., Bone Tumors): While rare, tumors of the bone or soft tissue around the elbow could cause pain, especially with activities like lifting. These conditions are critical to diagnose early for effective treatment.
- Rare Diagnoses
- Entrapment Neuropathies (e.g., Radial or Ulnar Neuropathy): Although the patient denies numbness or tingling, certain neuropathies could present with pain as a primary symptom, especially if the nerve compression is intermittent or not severe enough to cause noticeable sensory deficits.
- Infectious or Inflammatory Arthritis: Conditions like septic arthritis or rheumatoid arthritis could cause elbow pain, though they would typically be accompanied by other systemic symptoms or signs of inflammation, which are not mentioned in the scenario.