Differential Diagnosis for a 40-year-old man with elbow and forearm pain
- Single most likely diagnosis
- Lateral Epicondylitis (Tennis Elbow): This condition is characterized by pain on the lateral side of the elbow, which worsens with activities that involve gripping or twisting, such as work that requires repetitive wrist extension. The tenderness to palpation over the lateral epicondyle is a classic finding.
- Other Likely diagnoses
- Medial Epicondylitis (Golfer's Elbow): Although the pain is on the lateral side, medial epicondylitis can sometimes present with referred pain to the forearm and can affect grip strength. It's less likely given the lateral tenderness but should be considered.
- Radial Tunnel Syndrome: This condition involves compression of the radial nerve and can cause pain in the back of the hand and the forearm, which might radiate to the elbow area. It could affect grip strength and is worsened by activities that involve wrist extension.
- Elbow Strain or Sprain: Overuse or acute injury to the muscles and ligaments around the elbow could cause pain and tenderness, especially if the injury is on the lateral side.
- Do Not Miss diagnoses
- Fracture (e.g., Radial Head Fracture): Although less common, a fracture could present with pain and tenderness, especially if there was a recent trauma. Missing a fracture could lead to improper healing and long-term disability.
- Osteonecrosis of the Humeral Condyles: A condition where the blood supply to the bone tissue is interrupted, leading to bone death. It could present with elbow pain and is critical to diagnose early to prevent further damage.
- Infection (e.g., Osteomyelitis, Septic Arthritis): Infections in the bone or joint can present with pain, swelling, and tenderness. These conditions are medical emergencies and require prompt treatment.
- Rare diagnoses
- Tumors (e.g., Osteochondroma, Chondrosarcoma): Although rare, tumors could present with localized pain and tenderness. They are less likely but should be considered if other diagnoses are ruled out and symptoms persist.
- Entrapment Neuropathies (other than radial tunnel syndrome): Other nerves around the elbow could be compressed, leading to pain and weakness, though these would typically have more specific neurological symptoms.