Single most likely diagnosis
- Osteoarthritis: The patient's symptoms of progressive discomfort, morning stiffness, and pain in the hands, particularly on the radial side of the wrist, are consistent with osteoarthritis. The fact that she is postmenopausal also increases her risk for osteoarthritis.
Other Likely diagnoses
- Carpal tunnel syndrome: The patient's complaint of pain on the radial side of her wrist could be related to carpal tunnel syndrome, especially if she experiences numbness or tingling in her hands.
- Lateral epicondylitis: The patient's history of playing tennis and golf, which involve repetitive wrist motions, increases her risk for lateral epicondylitis, also known as tennis elbow.
Do Not Miss
- Gout: Although less likely, gout should be considered in the differential diagnosis, especially if the patient experiences sudden, severe attacks of pain in her hands or wrists. Missing a diagnosis of gout could lead to inadequate treatment and potential long-term joint damage.
Rare diagnoses
- Olecranon bursitis: This condition is less likely given the patient's symptoms, but it could be considered if she experiences swelling or pain at the elbow. However, her primary complaint is hand and wrist pain, making this diagnosis less probable.
- Other rheumatologic conditions, such as rheumatoid arthritis or psoriatic arthritis, could also be considered, although they are less likely given the patient's age and symptom profile.