Differential Diagnosis

• Single most likely diagnosis
  • D) Inflammation within the first dorsal extensor tendon compartment: This is the most likely diagnosis, as the patient's symptoms of pain on the dorsal and radial side of the wrist, particularly with motion of the thumb and forced ulnar deviation, are consistent with De Quervain's tenosynovitis. This condition involves inflammation of the tendons on the thumb side of the wrist, which can cause pain and tenderness, especially when moving the thumb.
• Other Likely diagnoses
  • A) Arthritis of the base of the thumb: This could be a possible diagnosis, given the patient's complaint of pain with thumb motion. However, arthritis would typically cause more persistent and widespread pain, rather than the intermittent pain described.
  • C) Elevated intracarpal canal pressure: This condition, also known as carpal tunnel syndrome, could cause wrist pain and numbness, but it typically affects the median nerve and causes symptoms in the palmar aspect of the hand, rather than the dorsal and radial side.
• Do Not Miss diagnoses
  • B) Compression of the ulnar nerve in Guyon canal: Although less likely, ulnar nerve compression could cause wrist pain and should not be missed, as it can lead to permanent nerve damage if left untreated. However, the symptoms described do not typically match those of ulnar nerve compression.
  • E) Radial nerve neuroma: This is a less common condition, but it could cause pain and numbness on the radial side of the wrist and hand. It is essential to consider this diagnosis to avoid missing a potentially treatable condition.
• Rare diagnoses
  • Other rare conditions, such as ganglion cysts or wrist tumors, could cause similar symptoms but are less likely given the patient's presentation and occupation as a typist, which increases the risk of repetitive strain injuries like De Quervain's tenosynovitis.