Differential Diagnosis for Suspected Fracture of the Right Middle Finger

The following differential diagnoses are considered based on the patient's symptoms and physical examination findings:

• Single Most Likely Diagnosis
  • Undisplaced fracture of the right middle finger: This is the most likely diagnosis given the patient's history of trauma, swelling, tenderness, and point tenderness over the middle finger knuckle. The normal X-ray does not completely rule out an undisplaced fracture, as some fractures may not be visible on initial X-ray.
• Other Likely Diagnoses
  • Ligament strain: The patient's symptoms of swelling, tenderness, and reduced range of motion are consistent with a ligament strain. The normal X-ray supports this diagnosis, as ligament strains do not involve bony abnormalities.
  • Soft tissue injury: The patient's trauma and subsequent swelling and tenderness could be due to a soft tissue injury, such as a bruise or contusion.
• Do Not Miss Diagnoses
  • Scaphoid fracture: Although the patient's wrist movement is normal without pain, a scaphoid fracture is a possible diagnosis that should not be missed. Scaphoid fractures can be difficult to diagnose and may not be visible on initial X-ray.
  • Compartment syndrome: This is a rare but serious condition that can occur after trauma to the hand or arm. The patient's symptoms of swelling, tenderness, and aching in the right arm could be indicative of compartment syndrome.
• Rare Diagnoses
  • Infection or abscess: Although unlikely, an infection or abscess could cause the patient's symptoms of swelling, tenderness, and pain.
  • Tumor or cyst: A tumor or cyst could cause the patient's symptoms, although this is a rare possibility and would likely require further imaging and diagnostic testing to confirm.