Differential Diagnosis for 15 YOM with Wrist Pain
Single Most Likely Diagnosis
- Ganglion Cyst: The location of the pain on the volar aspect of the wrist, just off midline towards the ulnar side, is consistent with a ganglion cyst, which is a common cause of wrist pain in young individuals. The exacerbation of pain with wrist flexion and activities like scrubbing the floor also supports this diagnosis.
Other Likely Diagnoses
- Triangular Fibrocartilage Complex (TFCC) Injury: The ulnar-sided wrist pain, especially with activities that involve wrist flexion, could suggest a TFCC injury. This is a common injury in individuals who participate in sports or activities that involve repetitive wrist motion.
- Wrist Tendinitis: Tendinitis of the wrist flexor tendons could cause pain on the volar aspect of the wrist, worsened by activities that involve wrist flexion, such as scrubbing the floor.
- Ulnar Nerve Irritation: Irritation of the ulnar nerve at the wrist could cause pain and tenderness in the area described, especially with activities that involve flexion or pressure on the nerve.
Do Not Miss Diagnoses
- Infectious Tenosynovitis: Although less likely, infectious tenosynovitis is a serious condition that requires prompt diagnosis and treatment. It could present with pain, swelling, and tenderness over the affected tendon, and the patient's recent activity of scrubbing the floor could potentially introduce infection if there was an open wound.
- Osteomyelitis or Septic Arthritis: These are serious infections of the bone or joint, respectively, which could present with localized pain, redness, and swelling. While less common, they are critical to diagnose early to prevent long-term damage.
Rare Diagnoses
- Kienböck's Disease: A rare condition involving the collapse of the lunate bone in the wrist, which could cause chronic wrist pain. It is less likely given the acute presentation but should be considered in the differential for chronic or unexplained wrist pain.
- Gout or Pseudogout: Although rare in a 15-year-old, these conditions could cause acute, severe wrist pain and should be considered if other diagnoses are ruled out, especially if there's a history of similar episodes or a family history of these conditions.