Differential Diagnosis for Palmar Surface Hand Pain
- Single most likely diagnosis
- Carpal Tunnel Syndrome (CTS): The patient's symptoms of palmar surface hand pain radiating to the 4th digit, numbness, and limited range of motion (ROM) are classic for CTS. The patient's occupation as a housekeeper, which likely involves repetitive hand movements, also supports this diagnosis.
- Other Likely diagnoses
- Ulnar Nerve Entrapment: The patient's symptoms of pain and numbness radiating to the 4th digit could also be consistent with ulnar nerve entrapment, particularly if the pain is more pronounced on the ulnar side of the hand.
- Tendinitis or Tenosynovitis: The patient's occupation and symptoms of hand pain and limited ROM could also suggest tendinitis or tenosynovitis, particularly if the pain is more localized to a specific tendon or area.
- Ganglion Cyst: A ganglion cyst could cause pain and limited ROM, particularly if it is located on the palmar surface of the hand and is compressing nearby nerves or tendons.
- Do Not Miss diagnoses
- Thoracic Outlet Syndrome (TOS): Although less likely, TOS could cause similar symptoms of hand pain and numbness, particularly if the patient has a history of trauma or anatomical abnormalities.
- Peripheral Artery Disease (PAD): PAD could cause hand pain and numbness, particularly if the patient has a history of vascular disease or risk factors.
- Median or Ulnar Neuroma: A neuroma could cause pain and numbness in the hand, particularly if it is located in the median or ulnar nerve distribution.
- Rare diagnoses
- Amyloidosis: Amyloidosis could cause carpal tunnel syndrome-like symptoms, particularly if the patient has a history of systemic disease.
- Sarcoidosis: Sarcoidosis could cause peripheral neuropathy or nerve entrapment, leading to hand pain and numbness.
- Tumor or Cyst: A tumor or cyst in the hand or wrist could cause pain and limited ROM, particularly if it is compressing nearby nerves or tendons.