Differential Diagnosis for 75-year-old Male with Pain Behind Left Ear/Left Upper Neck
- Single most likely diagnosis:
- Temporomandibular joint (TMJ) disorder: Given the location of the pain behind the left ear and the absence of systemic symptoms like fever, a TMJ disorder is a plausible explanation. The mild swelling in the ear canal could be related to referred pain or secondary to the TMJ issue.
- Other Likely diagnoses:
- Cervical spondylosis or neck strain: The pain in the left upper neck and below the ear could be indicative of a musculoskeletal issue such as cervical spondylosis or a simple neck strain.
- Ear canal inflammation or external otitis: Although there's no redness, the mild swelling in the ear canal might suggest an early stage of external otitis or another form of ear canal inflammation.
- Dental issues: Referred pain from dental problems can sometimes manifest as pain in the ear or neck area.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Temporal arteritis: Although less common, temporal arteritis (giant cell arteritis) is a critical diagnosis to consider in older adults presenting with head or neck pain, due to its potential for serious complications like vision loss if not promptly treated.
- Carotid artery dissection: Sudden onset of neck pain can be a symptom of carotid artery dissection, which is a medical emergency due to the risk of stroke.
- Malignancy: Although rare, pain in the neck or ear area could be a symptom of a malignancy, such as a tumor affecting the ear, neck, or parotid gland.
- Rare diagnoses:
- Eagle syndrome: This condition, caused by an elongated styloid process, can lead to pain in the ear and neck area, although it is relatively rare.
- Occipital neuralgia: Inflammation of the occipital nerves can cause pain in the neck and head, which might be perceived behind the ear.
- Parotid gland disorders: Conditions affecting the parotid gland, such as parotitis or a parotid tumor, could potentially cause pain in the area described.