Differential Diagnosis for Left Lateral Elbow Pain
Single Most Likely Diagnosis
- Lateral Epicondylitis (Tennis Elbow): This condition is characterized by pain on the lateral aspect of the elbow, often resulting from repetitive strain on the forearm extensors. The patient's history of repetitive motions at work, such as digging and planting, and the onset of pain after a pulling motion, strongly supports this diagnosis. The fact that ibuprofen provides moderate relief and pain worsens towards the end of the day also aligns with lateral epicondylitis.
Other Likely Diagnoses
- Radial Tunnel Syndrome: This condition involves compression of the radial nerve and can cause pain on the lateral aspect of the elbow, similar to lateral epicondylitis. The patient's occupation and activities could contribute to nerve compression, making this a plausible diagnosis.
- Elbow Strain: Given the patient's recent increase in physical activity, particularly the repetitive motions involved in farm work, an elbow strain could be a contributing factor to the pain. This would be more of an acute injury but could persist if the offending activities continue.
Do Not Miss Diagnoses
- Fracture or Avulsion Injury: Although less likely given the gradual onset and nature of the pain, it's crucial not to miss a fracture or avulsion injury, especially if the patient experienced significant trauma during the pulling motion. These conditions require immediate medical attention.
- Infection (Osteomyelitis or Septic Arthritis): Infections around the elbow joint or bone can present with pain and would be a medical emergency. While the patient's history does not strongly suggest an infectious cause, it's essential to consider this possibility, especially if the patient shows signs of systemic illness or if the pain is severe and unrelenting.
Rare Diagnoses
- Rheumatologic Conditions (e.g., Rheumatoid Arthritis, Psoriatic Arthritis): These conditions can cause elbow pain but are less likely given the lateral location of the pain and the absence of other systemic symptoms or joint involvement mentioned in the history.
- Tumors (Benign or Malignant): Tumors around the elbow could cause localized pain. However, they would be rare and typically present with other symptoms such as a mass, night pain not relieved by rest, or systemic symptoms like weight loss.