Differential Diagnosis for Joint Stiffness in the Morning
- Single most likely diagnosis
- Osteoarthritis: This is the most common cause of joint stiffness, especially in the morning, due to the wear and tear of joint cartilage. The patient's age and symptom of morning stiffness are consistent with this diagnosis.
- Other Likely diagnoses
- Rheumatoid Arthritis: An autoimmune disorder that causes inflammation and stiffness in the joints, often worse in the morning. The symmetry of joint involvement and presence of other systemic symptoms can help differentiate it from osteoarthritis.
- Psoriatic Arthritis: A type of arthritis that occurs in some people with psoriasis, characterized by joint stiffness, especially in the morning, along with skin and nail changes.
- Fibromyalgia: A condition characterized by widespread muscle pain, fatigue, and tender points, which can also cause morning stiffness.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Septic Arthritis: A bacterial infection within a joint, which is a medical emergency requiring prompt treatment. Symptoms can include sudden onset of joint pain, swelling, and stiffness, along with systemic signs of infection like fever.
- Crystal Arthropathies (Gout or Pseudogout): Conditions caused by the deposition of crystals within the joints, leading to sudden, severe joint pain and stiffness. While not typically deadly, they can cause significant morbidity if not treated promptly.
- Rare diagnoses
- Hemochromatosis: A genetic disorder leading to iron overload, which can cause joint stiffness and pain, among other systemic symptoms, due to iron deposition in the joints.
- Sarcoidosis: An inflammatory disease that can affect multiple parts of the body, including the joints, causing stiffness and pain.
- Lyme Arthritis: A complication of Lyme disease, caused by a bacterial infection, leading to joint stiffness and pain, particularly in the knees.