Differential Diagnosis for Chronic Elbow Pain
Single Most Likely Diagnosis
- Lateral Epicondylitis (Tennis Elbow): This is the most common cause of chronic elbow pain, especially in individuals who engage in repetitive wrist extension activities. The pain is typically localized to the lateral aspect of the elbow.
Other Likely Diagnoses
- Medial Epicondylitis (Golfer's Elbow): Similar to lateral epicondylitis but affects the medial aspect of the elbow, often due to repetitive wrist flexion activities.
- Olecranon Bursitis: Inflammation of the bursa at the back of the elbow, which can be caused by repetitive elbow flexion, direct trauma, or infection.
- Elbow Osteoarthritis: Degenerative joint disease that can cause chronic pain and stiffness in the elbow, more common in older adults.
- Radial Head Fracture or Arthritis: Can cause chronic elbow pain, especially with rotation or flexion of the forearm.
Do Not Miss Diagnoses
- Infectious Arthritis: Although less common, infectious causes of elbow pain (e.g., septic arthritis) are medical emergencies that require prompt diagnosis and treatment to prevent serious complications.
- Tumor or Cyst: Rarely, chronic elbow pain can be due to a tumor (e.g., osteochondroma) or a cyst (e.g., ganglion cyst) that may not be immediately apparent but could have significant implications if missed.
- Neurological Conditions: Such as ulnar nerve entrapment or radial nerve compression, which can cause chronic pain and other neurological symptoms in the elbow and forearm.
Rare Diagnoses
- Elbow Gout or Pseudogout: Deposition of urate or calcium pyrophosphate crystals within the elbow joint can cause acute or chronic pain.
- Spondyloarthritis: Conditions like ankylosing spondylitis or psoriatic arthritis can affect the elbow, though this is less common.
- Osteonecrosis of the Elbow: A rare condition where the bone tissue dies due to lack of blood supply, potentially causing chronic elbow pain.
- Complex Regional Pain Syndrome (CRPS): A chronic pain condition that can affect the elbow, characterized by severe, burning pain and sensitivity.