Differential Diagnosis for a 30-year-old man with pain and swelling at the right wrist

• Single most likely diagnosis
  • Trauma or Sprain: This is the most common cause of wrist pain and swelling, especially in a young adult. A recent history of fall or injury would support this diagnosis.
• Other Likely diagnoses
  • Osteoarthritis: Although less common in young adults, osteoarthritis can occur, especially if there's a history of previous wrist injury or repetitive strain.
  • Gout: Acute gouty arthritis can cause sudden onset of pain and swelling in the wrist, especially if the patient has a history of gout or hyperuricemia.
  • Infectious Arthritis: Bacterial or viral infections can cause wrist pain and swelling, and this diagnosis should be considered, especially if there's fever, redness, or warmth around the wrist.
  • Tendinitis: Inflammation of the tendons surrounding the wrist can cause pain and swelling, often related to overuse or repetitive strain.
• Do Not Miss diagnoses
  • Septic Arthritis: Although less likely, septic arthritis is a medical emergency that requires prompt diagnosis and treatment to prevent joint destruction and systemic complications.
  • Fracture: A fracture, especially a scaphoid fracture, can be easily missed and requires prompt diagnosis to prevent long-term complications such as avascular necrosis.
  • Ligamentous Injury: Serious ligamentous injuries, such as a scapholunate ligament injury, can have significant long-term consequences if not properly diagnosed and treated.
• Rare diagnoses
  • Pseudogout: Calcium pyrophosphate deposition disease (CPPD) can cause acute arthritis, including in the wrist, although it's less common in young adults.
  • Hemarthrosis: Bleeding into the joint space can occur due to various reasons, including trauma, bleeding disorders, or vascular malformations.
  • Tumor or Cyst: Benign or malignant tumors, or cysts such as a ganglion cyst, can cause wrist pain and swelling, although these are less common causes.