Differential Diagnosis for Buffalo Hump

Besides Cushing's disease, a buffalo hump can be caused by various conditions. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis

  • Obesity: A buffalo hump, also known as a dorsocervical fat pad, can be a result of excess fat accumulation in the upper back, often associated with obesity. This is a common and straightforward explanation for the presence of a buffalo hump.

• Other Likely Diagnoses

  • Lipodystrophy: This condition involves the abnormal distribution of body fat and can lead to the accumulation of fat in the upper back, resulting in a buffalo hump.
  • Hypothyroidism: Although less common, hypothyroidism can cause changes in fat distribution, including the development of a buffalo hump.
  • Medication side effects: Certain medications, such as steroids and some antiretroviral drugs, can cause fat redistribution and lead to the formation of a buffalo hump.

• Do Not Miss Diagnoses

  • Multiple Myeloma: This type of blood cancer can cause a buffalo hump due to the accumulation of malignant plasma cells in the bone marrow, leading to bone lesions and subsequent fat accumulation.
  • Tuberculosis: In rare cases, tuberculosis can cause a buffalo hump, especially if it affects the spine or the surrounding tissues.

• Rare Diagnoses

  • Madelung's disease: A rare condition characterized by the accumulation of fat in the neck and upper back, resulting in a buffalo hump.
  • Familial partial lipodystrophy: A genetic disorder that affects fat distribution, potentially leading to the development of a buffalo hump.
  • Pseudohypoparathyroidism: A rare genetic disorder that can cause changes in fat distribution, including the formation of a buffalo hump.