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Differential Diagnosis for Radial-Sided Wrist Pain

Single Most Likely Diagnosis

  • De Quervain's Tenosynovitis: This condition is characterized by inflammation of the tendons on the radial side of the wrist, which is consistent with the patient's symptoms. The pain is exacerbated by activities that involve lifting, grasping, or twisting, such as lifting an infant into a car seat. The diagnosis is often made clinically, based on the patient's history and physical examination findings, including the Finkelstein test.

Other Likely Diagnoses

  • Radial Wrist Sprain: Although the patient denies acute trauma, a sprain could have occurred without her realizing it, especially if it was a minor injury. The symptoms could be consistent with a radial wrist sprain, especially if there is pain and tenderness over the radial aspect of the wrist.
  • Wrist Tendinitis: Tendinitis of the wrist extensors or flexors could also cause radial-sided wrist pain, especially if the patient has been performing repetitive activities with her wrist.
  • Ganglion Cyst: A ganglion cyst is a benign lump that can occur on the wrist, often causing pain and discomfort, especially if it is pressing on a nearby nerve or tendon.

Do Not Miss Diagnoses

  • Scaphoid Fracture: Although the patient denies acute trauma, a scaphoid fracture could have occurred without her realizing it, and it is a diagnosis that should not be missed due to the risk of complications such as avascular necrosis and nonunion.
  • Osteonecrosis of the Lunate (Kienbock's Disease): This is a rare condition, but it is a "do not miss" diagnosis due to the potential for serious complications if left untreated.
  • Infectious Tenosynovitis: This is a serious condition that requires prompt treatment with antibiotics, and it should not be missed due to the risk of serious complications such as tendon rupture and permanent damage.

Rare Diagnoses

  • Gout or Pseudogout: These conditions can cause sudden, severe wrist pain, but they are less likely in a 35-year-old female without a history of these conditions.
  • Tumor or Cyst: A tumor or cyst on the wrist could cause pain and discomfort, but these are rare conditions and would likely be associated with other symptoms such as a palpable mass or swelling.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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