Differential Diagnosis for 44 yo Female with Chronic Polyarthralgia, Myalgia, Fatigue, Episodic Neuropathic Pain, Bilateral Foot Pain, and Heel Pain
- Single Most Likely Diagnosis
- Fibromyalgia: This condition is characterized by widespread musculoskeletal pain, fatigue, sleep, memory, and mood issues, which aligns with the patient's symptoms of chronic polyarthralgia, myalgia, and fatigue.
- Other Likely Diagnoses
- Rheumatoid Arthritis (RA): Although the patient's symptoms do not specifically mention joint swelling or morning stiffness, RA can cause polyarthralgia, fatigue, and foot pain, making it a plausible diagnosis.
- Osteoarthritis: This condition could explain the bilateral foot pain and heel pain, especially if the patient has a history of trauma, repetitive strain, or age-related wear and tear.
- Peripheral Neuropathy: The episodic neuropathic pain could be indicative of peripheral neuropathy, which might be caused by diabetes, vitamin deficiencies, or other underlying conditions.
- Do Not Miss Diagnoses
- Multiple Myeloma: Although rare, multiple myeloma can cause bone pain, fatigue, and neuropathic pain, making it crucial to rule out, especially in older adults.
- Lyme Disease: If the patient has a history of tick exposure, Lyme disease could be a consideration, as it can cause arthritis, neuropathic pain, and fatigue.
- Vasculitis: Conditions like giant cell arteritis or polyarteritis nodosa can cause systemic symptoms, including fatigue, pain, and neuropathy, and are important to diagnose early to prevent complications.
- Rare Diagnoses
- Sjögren's Syndrome: This autoimmune disorder can cause arthritis, fatigue, and neuropathic pain, but it is less common and typically associated with dry eyes and mouth.
- Sarcoidosis: This condition can cause musculoskeletal pain, fatigue, and neuropathy, but it is relatively rare and often associated with lung or skin involvement.
- Erythromelalgia: A rare condition characterized by burning pain, heat, and redness in the hands and feet, which could explain the patient's bilateral foot pain and heel pain.