Differential Diagnosis for Ulnar Side Wrist Pain
Single Most Likely Diagnosis
- Ulnar impaction syndrome: This condition is characterized by chronic pain on the ulnar side of the wrist due to the impaction of the ulna against the radius and/or the carpal bones, often due to an ulnar positive variance. It's a common cause of ulnar-sided wrist pain, especially in individuals who participate in activities that involve repetitive forearm rotation.
Other Likely Diagnoses
- Triangular fibrocartilage complex (TFCC) injury: The TFCC is a ligamentous structure that supports the wrist and forearm. Injuries to the TFCC can cause ulnar-sided wrist pain, especially with rotational movements or weight-bearing activities.
- Ulnar styloid fracture or nonunion: A fracture or nonunion of the ulnar styloid can cause chronic pain on the ulnar side of the wrist, often accompanied by decreased grip strength and limited wrist motion.
- Extensor carpi ulnaris (ECU) tendonitis: Inflammation of the ECU tendon can cause pain on the ulnar side of the wrist, particularly with activities that involve wrist extension and ulnar deviation.
Do Not Miss Diagnoses
- Gout or pseudogout: Although less common, crystalline arthropathies like gout or pseudogout can cause acute, severe wrist pain, including on the ulnar side. Missing these diagnoses can lead to prolonged morbidity and potential long-term joint damage.
- Infection (septic arthritis or osteomyelitis): Infections in the wrist can cause severe pain, swelling, and redness. Early diagnosis and treatment are crucial to prevent long-term damage and potential systemic complications.
- Ganglion cyst: While often benign, a ganglion cyst on the ulnar side of the wrist can cause significant pain and discomfort, especially if it compresses nearby nerves or tendons.
Rare Diagnoses
- Kienböck's disease: A rare condition characterized by the collapse of the lunate bone, which can cause chronic wrist pain, including on the ulnar side.
- Madelung's deformity: A congenital condition that affects the distal radius and ulna, leading to abnormal growth and potential chronic pain on the ulnar side of the wrist.
- Tumors (e.g., giant cell tumor of the tendon sheath): Although rare, tumors can cause chronic pain and swelling on the ulnar side of the wrist, often accompanied by other systemic symptoms.