Differential Diagnosis for Unable to Straighten Fingers with Shooting Pain to the Elbow

• Single Most Likely Diagnosis
  • Tennis Elbow (Lateral Epicondylitis): This condition is characterized by pain on the outer part of the elbow, which can radiate down to the forearm and wrist, and is often associated with difficulty extending the wrist and fingers due to inflammation of the tendons. The shooting pain to the elbow when trying to straighten the fingers aligns with the typical presentation of tennis elbow.
• Other Likely Diagnoses
  • Medial Epicondylitis (Golfer's Elbow): Although the pain is typically on the inner aspect of the elbow, it can also cause difficulty with finger extension and may radiate pain to the forearm, potentially causing discomfort when straightening the fingers.
  • Radial Tunnel Syndrome: This condition involves compression of the radial nerve and can cause pain in the back of the hand or the thumb side of the hand, which might extend to the elbow, and can lead to difficulty extending the wrist or fingers.
  • Cubital Tunnel Syndrome: Involves compression of the ulnar nerve at the elbow, leading to symptoms such as numbness, tingling, and pain in the hand and fingers, and potentially weakness that could affect finger extension.
• Do Not Miss Diagnoses
  • Acute Compartment Syndrome: A medical emergency that occurs when pressure within the muscle compartments increases to dangerous levels, cutting off blood flow and potentially leading to nerve and muscle damage. Symptoms can include severe pain, especially on extension of the fingers, and paresthesias.
  • Infectious Arthritis or Osteomyelitis: Infections within the joints or bones of the elbow or forearm can cause severe pain, swelling, and decreased range of motion, including an inability to straighten the fingers, and are medical emergencies.
• Rare Diagnoses
  • Tumors (e.g., Osteochondroma, Giant Cell Tumor): Although rare, tumors around the elbow can cause pain, swelling, and mechanical symptoms such as limited range of motion due to the mass effect.
  • Peripheral Nerve Tumors (e.g., Schwannoma, Neurofibroma): Can compress nerves, leading to pain, weakness, and sensory changes, potentially affecting the ability to extend the fingers if the radial or ulnar nerves are involved.