Differential Diagnosis for Photophobia and Migratory Arthritis

Single Most Likely Diagnosis

• Lyme Disease: This is a common condition that can cause both photophobia and migratory arthritis, especially in individuals who have been exposed to ticks. The arthritis often affects large joints and can migrate from one joint to another.

Other Likely Diagnoses

• Viral Arthritis (e.g., Parvovirus, Rubella): Certain viral infections can lead to arthritis that may be migratory and can also cause systemic symptoms such as fever and malaise, which might indirectly contribute to photophobia.
• Rheumatoid Arthritis (RA): Although RA typically causes more symmetric joint involvement, it can occasionally present with migratory symptoms and is associated with a variety of systemic symptoms, including potential eye issues that might lead to photophobia.
• Systemic Lupus Erythematosus (SLE): SLE is a systemic autoimmune disease that can cause arthritis, skin rashes, and a variety of other symptoms, including photosensitivity and eye issues that might result in photophobia.

Do Not Miss Diagnoses

• Meningitis: This is a potentially life-threatening condition that can cause photophobia (due to meningeal irritation) and, in some cases, arthritis (especially if caused by certain bacteria like Neisseria meningitidis). Early diagnosis and treatment are crucial.
• Endocarditis: Infective endocarditis can cause systemic symptoms, including arthritis and eye symptoms (such as Roth spots), which might lead to photophobia. It's a serious condition that requires prompt diagnosis and treatment.
• Sarcoidosis: This condition can cause a wide range of symptoms, including arthritis, eye inflammation (which might lead to photophobia), and systemic symptoms. It's important not to miss due to its potential for serious complications if left untreated.

Rare Diagnoses

• Whipple's Disease: A rare, systemic bacterial infection that can cause migratory arthritis, among other symptoms. Eye involvement is less common but can occur.
• Relapsing Polychondritis: An autoimmune disorder that can cause inflammation of cartilage and other tissues, leading to arthritis and potentially eye symptoms, including photophobia.
• Behçet's Disease: A form of vasculitis that can cause a wide range of symptoms, including arthritis, eye inflammation (which might lead to photophobia), and skin lesions. It's rare but important to consider due to its potential for serious complications.