Differential Diagnosis for Severe Pain in Elbow Sudden Onset
- Single Most Likely Diagnosis
- Elbow Fracture: A sudden onset of severe pain in the elbow is highly suggestive of a fracture, particularly if there was a traumatic event or fall onto an outstretched hand. The mechanism of injury and immediate pain are key indicators.
- Other Likely Diagnoses
- Elbow Dislocation: Similar to a fracture, a dislocation can cause sudden severe pain and is often associated with a traumatic event. The deformity and instability of the elbow joint can be a clue.
- Radial Head Fracture: A specific type of fracture that occurs at the radial head, which is a common injury from a fall onto an outstretched hand. Pain and decreased rotation of the forearm are typical symptoms.
- Olecranon Bursitis: Although typically more of an inflammatory condition, acute olecranon bursitis can present with sudden pain if caused by a direct blow to the elbow. Swelling and redness over the olecranon process are characteristic.
- Do Not Miss Diagnoses
- Compartment Syndrome: A medical emergency that can result from increased pressure within the compartments of the elbow, potentially leading to nerve and muscle damage. Severe pain out of proportion to the injury, pallor, poikilothermia, paresthesia, and pulselessness are the "5 Ps" of compartment syndrome.
- Brachial Artery Injury: Damage to the brachial artery can lead to severe ischemia of the forearm and hand, necessitating immediate intervention. Symptoms include severe pain, pallor, decreased pulses in the wrist, and potentially neurological deficits.
- Rare Diagnoses
- Panner Disease: A rare condition affecting the capitellum of the humerus, typically in young athletes involved in throwing sports. It presents with gradual onset pain but can occasionally seem sudden if the patient has been ignoring symptoms.
- Synovial Chondromatosis: A rare condition characterized by the growth of cartilage in the synovium of the joint, leading to pain, swelling, and decreased range of motion. It's more chronic but can have acute exacerbations.
- Gout or Pseudogout: Although more commonly affecting the lower extremities, these conditions can cause sudden, severe pain in the elbow due to crystal deposition. They are less common in the elbow but should be considered, especially in patients with a history of these conditions.