Differential Diagnosis for Waking Up Exhausted with Aching Joints When It Rains

• Single Most Likely Diagnosis
  • Hypermobile Ehlers-Danlos Syndrome (hEDS): This condition is characterized by joint hypermobility, musculoskeletal pain, and other systemic symptoms. The exacerbation of symptoms by weather changes, such as rain, is a common complaint among patients with hEDS, likely due to changes in atmospheric pressure affecting joint pain and stiffness.
• Other Likely Diagnoses
  • Fibromyalgia: A chronic condition marked by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Weather sensitivity is a recognized symptom, with many patients reporting increased pain and fatigue during rainy or humid weather.
  • Rheumatoid Arthritis (RA): An autoimmune disorder that causes inflammation and pain in the joints. While RA can cause persistent joint pain and stiffness, some patients may experience weather-related fluctuations in symptoms, including during rainy weather.
  • Osteoarthritis: A degenerative joint disease that can cause pain and stiffness, particularly in older adults. Changes in weather, including rain, can exacerbate symptoms in some individuals, possibly due to changes in barometric pressure.
• Do Not Miss Diagnoses
  • Lyme Disease: A bacterial infection transmitted by tick bites, which can cause arthritis, fatigue, and musculoskeletal pain. Early diagnosis and treatment are crucial to prevent long-term complications, making it essential to consider in patients with unexplained joint pain and fatigue, especially if they spend time outdoors.
  • Multiple Sclerosis (MS): A chronic autoimmune disease affecting the central nervous system, which can cause fatigue, musculoskeletal pain, and a variety of other neurological symptoms. While less directly related to weather changes, MS should be considered in the differential diagnosis due to its potential for significant morbidity if left untreated.
• Rare Diagnoses
  • Marfan Syndrome: A genetic disorder that affects the body's connective tissue, leading to symptoms such as joint pain, fatigue, and musculoskeletal abnormalities. While it shares some features with hEDS, Marfan Syndrome typically involves more pronounced cardiovascular and ocular manifestations.
  • Mixed Connective Tissue Disease (MCTD): An autoimmune disorder that combines features of lupus, scleroderma, and rheumatoid arthritis, including joint pain, fatigue, and musculoskeletal symptoms. It is less common than the other conditions listed but should be considered in patients with a complex array of symptoms.