What is the diagnosis and treatment for a 48-year-old male presenting with right elbow pain and limited extension after a fall onto the elbow, with a small abrasion, and uncertain tetanus (tetanus toxoid) status?

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Differential Diagnosis for Right Elbow Pain

The patient presents with right elbow pain after a fall, which can lead to various potential diagnoses. Here's a categorized list of possible causes:

  • Single most likely diagnosis
    • Olecranon Bursitis: This condition is likely given the patient's history of falling on their elbow, which can cause inflammation of the bursa at the olecranon. The pain with extension of the arm also supports this diagnosis.
  • Other Likely diagnoses
    • Radial Head Fracture: A fall onto the elbow can cause a fracture of the radial head, leading to pain and limited mobility.
    • Elbow Contusion: The patient's mechanism of injury and the presence of an abrasion suggest a contusion, which can cause pain and swelling.
    • Elbow Sprain: Ligament sprains can occur from a fall, especially if the elbow was twisted or bent during the injury.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Septic Arthritis: Although the patient cleaned and applied antibiotic ointment to the abrasion, there is still a risk of infection, especially if the wound was contaminated with dirt or water. Septic arthritis is a medical emergency that requires prompt treatment.
    • Compartment Syndrome: This condition can occur after a traumatic injury, causing increased pressure within the muscle compartments, which can lead to nerve and muscle damage if not treated promptly.
  • Rare diagnoses
    • Ulnar Nerve Injury: The ulnar nerve runs close to the surface of the elbow and can be injured in a fall, causing numbness, tingling, and weakness in the hand.
    • Elbow Dislocation: Although less common, a dislocation can occur from a severe fall, causing significant pain and deformity.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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