Differential Diagnosis for Thumb and Wrist Pain with Circular Thumb Movement

• Single Most Likely Diagnosis
  • De Quervain's tenosynovitis: This condition, which affects the tendons on the thumb side of your wrist, can cause pain and tenderness, especially when forming a fist, grasping, or turning the wrist. The pain is typically exacerbated by activities that involve repetitive thumb movement, such as circular motions.
• Other Likely Diagnoses
  • Thumb carpometacarpal (CMC) joint arthritis: Arthritis in the joint at the base of the thumb can cause pain and stiffness, particularly with movements like grasping or twisting, which could include circular thumb movements.
  • Wrist tendinitis: Inflammation of the tendons in the wrist can lead to pain and discomfort, especially with repetitive movements or specific actions like circular thumb movements.
  • Ganglion cyst: A lump or mass that forms on the wrist or thumb, which can cause pain, especially if it presses on a nerve or tendon, potentially worsening with certain movements.
• Do Not Miss Diagnoses
  • Scaphoid fracture: A fracture of one of the small bones in the wrist, which can be easily missed but is critical to diagnose due to the risk of complications like avascular necrosis if not properly treated. Pain with thumb movement could be a symptom.
  • Radial nerve compression: Compression of the radial nerve can cause pain, numbness, and weakness in the wrist and hand, including the thumb, and could be exacerbated by certain movements.
• Rare Diagnoses
  • Kienböck's disease: A rare condition where the blood supply to one of the bones in the wrist (the lunate) is interrupted, leading to its deterioration. It can cause wrist pain that might radiate to the thumb and could potentially be exacerbated by circular movements.
  • Giant cell tumor of the tendon sheath: A rare, benign tumor that can occur on the tendons of the wrist and thumb, causing pain and limited mobility, potentially worsening with specific movements.