Differential Diagnosis for Fibromyalgia
The patient's symptoms of widespread pain, brain fog, fatigue, and shooting pain sensation, as well as skin pain induced by temperature changes, can be evaluated against various potential diagnoses. Here's a categorized differential diagnosis:
- Single Most Likely Diagnosis
- Fibromyalgia: This diagnosis fits well with the patient's symptoms, including widespread pain, fatigue, brain fog, and sensitivity to temperature changes. Fibromyalgia is characterized by chronic, widespread musculoskeletal pain, fatigue, sleep, memory, and mood issues, which align with the patient's presentation.
- Other Likely Diagnoses
- Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): While the primary symptom is profound fatigue, patients often experience widespread pain and sensitivity to temperature, which could overlap with the patient's symptoms.
- Rheumatoid Arthritis: Although primarily an autoimmune disorder affecting the joints, rheumatoid arthritis can cause widespread pain, fatigue, and occasionally neurological symptoms like tingling or burning sensations.
- Lupus: Systemic lupus erythematosus is an autoimmune disease that can cause widespread pain, fatigue, and sensitivity to temperature changes, among other symptoms.
- Do Not Miss Diagnoses
- Multiple Sclerosis: A chronic and often disabling autoimmune disease affecting the central nervous system, multiple sclerosis can cause a wide range of symptoms including pain, fatigue, and sensory disturbances like burning or tingling, especially in response to temperature changes.
- Hypothyroidism: Although less directly related to pain and temperature sensitivity, untreated hypothyroidism can cause widespread muscle pain, fatigue, and cognitive issues, making it a condition not to miss due to its treatable nature.
- Lyme Disease: In its later stages, Lyme disease can cause widespread pain, fatigue, and neurological symptoms. Given its potential for serious complications if untreated, it's crucial not to miss this diagnosis.
- Rare Diagnoses
- Ehlers-Danlos Syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues, Ehlers-Danlos syndrome can cause widespread pain, fatigue, and unusual sensory symptoms.
- Small Fiber Neuropathy: A condition characterized by damage to the small nerve fibers in the skin, which can cause burning pain, usually in the feet or hands, but can also be widespread and accompanied by other symptoms like fatigue.
Each of these diagnoses has the potential to explain some or all of the patient's symptoms, and a thorough diagnostic workup, including medical history, physical examination, and appropriate laboratory tests, is necessary to determine the most accurate diagnosis.