Differential Diagnosis for 59-year-old Female with Joint Pains
Single Most Likely Diagnosis
- Rheumatoid Arthritis (RA): The patient's symptoms of joint pains, particularly involving small joints, and morning stiffness are classic for RA. The age and gender of the patient also fit the typical demographic for RA.
Other Likely Diagnoses
- Osteoarthritis (OA): Although OA more commonly affects larger joints, it can also involve smaller joints, especially in older adults. Morning stiffness is less common in OA but can occur.
- Seronegative Spondyloarthropathy: This includes conditions like psoriatic arthritis, which can present with small joint involvement and morning stiffness, although typically, there are other symptoms such as skin or eye involvement.
- Crystal Arthropathies (Gout or Pseudogout): These conditions can cause acute joint pain and stiffness, although they more commonly affect single joints at a time.
Do Not Miss Diagnoses
- Septic Arthritis: Although less likely given the lack of systemic symptoms, septic arthritis is a medical emergency that requires prompt diagnosis and treatment to prevent joint destruction.
- Lyme Arthritis: Caused by Borrelia burgdorferi, Lyme disease can cause arthritis, particularly in endemic areas. It's crucial to consider this diagnosis to initiate appropriate antibiotic treatment.
- Hematologic Malignancies (e.g., Leukemia or Lymphoma): These conditions can cause joint pains due to direct infiltration of the joints or associated rheumatologic syndromes.
Rare Diagnoses
- Relapsing Polychondritis: A rare autoimmune disorder that can cause joint pain and stiffness, among other symptoms like cartilage inflammation.
- Sjögren's Syndrome: An autoimmune disorder that can cause joint pain and stiffness, along with its hallmark symptoms of dry eyes and dry mouth.
- Mixed Connective Tissue Disease: A rare autoimmune disorder with overlapping features of lupus, scleroderma, and rheumatoid arthritis, which can cause joint pains and stiffness.