Differential Diagnosis for Intermittent Forearm Pain
Single Most Likely Diagnosis
- Exertional Compartment Syndrome: This condition is characterized by increased pressure within a muscle compartment, leading to pain, especially after intense or prolonged physical activity. The symptoms described, such as intermittent intense throbbing pain in the forearm after unusual physical exertion, align with this diagnosis. The fact that the pain is more prevalent in the morning and dissipates by the end of the day could be related to increased muscle activity and subsequent swelling during the day.
Other Likely Diagnoses
- Muscle Strain: Given the recent increase in physical activity, a strain of the forearm muscles could explain the pain. However, the intermittent and throbbing nature of the pain might be less typical for a simple strain.
- Tendinitis: Inflammation of the tendons in the forearm, possibly due to overuse from biking and kickball, could cause pain, especially with activity. The morning prevalence could be due to stiffness.
- Median or Ulnar Nerve Irritation: Compression or irritation of these nerves could cause forearm pain, but the description lacks typical neurological symptoms such as numbness or tingling.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Although less common in the forearm, DVT could present with pain and swelling. Given the potential for serious complications like pulmonary embolism, it's crucial to consider, especially if there are risk factors such as recent immobility or family history.
- Acute Arterial Occlusion: Sudden onset of severe forearm pain could indicate an arterial blockage, which is a medical emergency. However, this typically presents with more dramatic symptoms including pallor, pulselessness, poikilothermia, pain, paresthesias, and paralysis.
Rare Diagnoses
- Forearm Osteoid Osteoma: A benign bone tumor that could cause intermittent pain, typically worse at night and relieved by NSAIDs. The location and nature of the pain could fit, but it's less likely given the recent onset after physical activity.
- Peripheral Artery Disease (PAD): Intermittent claudication of the forearm, though rare, could present with activity-induced pain. However, this is more common in older individuals with risk factors for atherosclerosis.