Differential Diagnosis for Musculoskeletal Pain with Consumption of Meat

Single Most Likely Diagnosis

• Gout: This condition is characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, often occurring after consuming meat or seafood, which are high in purines. The pain is typically acute and can be extremely debilitating.

Other Likely Diagnoses

• Pseudogout (Calcium Pyrophosphate Deposition Disease, CPPD): Similar to gout, pseudogout causes sudden, severe joint pain, but it is due to the deposition of calcium pyrophosphate dihydrate crystals within the joint. While diet may not be as directly implicated as in gout, certain metabolic conditions associated with pseudogout could be influenced by dietary factors.
• Rheumatoid Arthritis (RA): An autoimmune disorder that causes chronic inflammation and pain in the joints. While not directly caused by meat consumption, some studies suggest that diet may play a role in the severity of symptoms or the onset of the disease in predisposed individuals.
• Fibromyalgia: A long-term condition characterized by widespread pain in the muscles and bones, areas of tenderness, and general fatigue. Dietary factors, including the consumption of certain meats, might exacerbate symptoms in some individuals, although the condition's cause is not directly related to diet.

Do Not Miss Diagnoses

• Scurvy: Caused by a severe deficiency of vitamin C, scurvy can lead to musculoskeletal pain among other symptoms. It's crucial to consider in individuals with very poor diets or specific dietary restrictions that might lead to vitamin C deficiency.
• Osteomalacia: A condition characterized by the softening of the bones due to a deficiency of vitamin D and calcium. While not directly linked to meat consumption, it's a critical diagnosis to consider due to its potential for severe consequences if left untreated.

Rare Diagnoses

• Alpha-Gal Syndrome: A recently identified type of food allergy to galactose-alpha-1,3-galactose (alpha-gal), a carbohydrate found in mammalian meat. It can cause anaphylaxis, and some patients may experience musculoskeletal symptoms.
• Whipple's Disease: A rare, systemic bacterial infection (Tropheryma whipplei) that can cause malabsorption and lead to musculoskeletal pain among a wide array of other symptoms. It's extremely rare but critical to diagnose due to its severity and the need for specific antibiotic treatment.