Differential Diagnosis for Migrating Pain

Migrating pain refers to pain that moves or changes location over time. This symptom can be associated with various conditions, ranging from benign to life-threatening. The differential diagnosis is organized into the following categories:

• Single Most Likely Diagnosis
  • Fibromyalgia: Characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. The pain in fibromyalgia can migrate and is often described as aching, burning, or stabbing.
• Other Likely Diagnoses
  • Rheumatoid Arthritis (RA): An autoimmune disorder that causes inflammation in the joints, leading to pain, swelling, and stiffness. The pain can migrate as different joints become involved.
  • Lupus: A chronic autoimmune disease that can affect various parts of the body, including the joints, skin, kidneys, and other organs. Migrating joint pain is a common symptom.
  • Viral Infections: Certain viral infections, such as the flu or mononucleosis, can cause body aches that may seem to migrate.
• Do Not Miss Diagnoses
  • Acute Intermittent Porphyria: A rare genetic disorder that can cause severe abdominal pain, neurological symptoms, and psychological disturbances. The pain can be migratory and is often accompanied by other systemic symptoms.
  • Temporal Arteritis: Inflammation of the blood vessels in the head, which can cause migratory pain, especially in the temples, and is associated with a significant risk of blindness if not promptly treated.
  • Abdominal Aortic Aneurysm: A condition where the aorta enlarges abnormally, which can cause severe, migratory abdominal and back pain. It is life-threatening if ruptured.
• Rare Diagnoses
  • Ehlers-Danlos Syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues. Some types can cause migratory joint pain.
  • Sjögren's Syndrome: An autoimmune disorder that primarily affects the glands that produce tears and saliva, but can also cause migratory joint pain and other systemic symptoms.
  • Mixed Connective Tissue Disease: An autoimmune disease that combines features of lupus, scleroderma, and rheumatoid arthritis, and can cause migratory pain among other symptoms.

Each of these diagnoses has a unique set of accompanying symptoms and diagnostic criteria. A thorough medical history, physical examination, and appropriate laboratory tests are essential for making an accurate diagnosis.