Differential Diagnosis for Left Wrist Swelling and Soreness
Single Most Likely Diagnosis
- Radiation-induced swelling: Given the patient's recent start of daily radiation treatments for lung cancer, it's plausible that the swelling is a side effect of radiation, possibly causing inflammation or fluid buildup in the wrist area. The lack of injury, overuse, or systemic symptoms supports this consideration.
Other Likely Diagnoses
- Idiopathic edema: This could be a possibility if the swelling is not directly related to the radiation therapy. Idiopathic edema can occur without a clear cause and might be localized to one area.
- Overuse or minor injury not recalled: Although the patient denies any injury or overuse, it's possible that a minor incident was forgotten or not recognized as significant.
- Early signs of infection: Despite the absence of redness, warmth to the touch could indicate the beginning of an infectious process, especially if the patient's immune system is compromised due to cancer treatment.
Do Not Miss Diagnoses
- Deep vein thrombosis (DVT): Although less common in the upper extremities, DVT could cause swelling and warmth. Given the patient's cancer and recent immobilization for radiation therapy, the risk of DVT might be increased.
- Superficial thrombophlebitis: Inflammation of a vein just under the skin could cause localized swelling, warmth, and pain.
- Cellulitis or abscess: An infection of the skin and subcutaneous tissues could present with localized swelling and warmth, even without significant redness initially.
- Compartment syndrome: A serious condition resulting from increased pressure within a muscle compartment, which could be caused by various factors including trauma, infection, or external compression.
Rare Diagnoses
- Sarcoidosis: A condition that can cause swelling and inflammation in various parts of the body, including the wrists, though it would be unusual for it to present so acutely and localized without other symptoms.
- Gout or pseudogout: These conditions can cause sudden, severe swelling and pain in joints, including the wrist, but are less likely given the patient's description and lack of previous episodes.
- Neoplastic processes: Direct invasion of the wrist by a metastatic lesion from the lung cancer, though rare and less likely without other systemic symptoms or a known history of metastasis to bone.