Differential Diagnosis for Thumb Pain
- Single most likely diagnosis
- Osteoarthritis: This is a common condition, especially in older adults, where the cartilage in the joints breaks down, leading to pain and stiffness. The thumb is a frequently affected area due to its high mobility and load-bearing function.
- Other Likely diagnoses
- Trigger thumb (Stenosing tenosynovitis): A condition where the tendon sheath surrounding the tendon of the thumb becomes inflamed, causing pain and a clicking sensation when moving the thumb.
- De Quervain's tenosynovitis: Inflammation of the tendons on the thumb side of the wrist, leading to pain and tenderness, especially when forming a fist, grasping, or turning the wrist.
- Thumb sprain: An injury to the ligaments surrounding the thumb joints, often resulting from sudden twisting or bending.
- Do Not Miss diagnoses
- Scaphoid fracture: A break in one of the small bones of the wrist, which can be easily missed but is crucial to diagnose early to prevent complications like avascular necrosis.
- Infectious tenosynovitis: A bacterial infection of the tendon sheath, which can lead to severe consequences if not promptly treated with antibiotics.
- Giant cell tumor of the tendon sheath: A rare, benign tumor that can cause pain and swelling, but is important to diagnose to rule out more serious conditions.
- Rare diagnoses
- Thumb gout: Deposition of urate crystals in the joints of the thumb, leading to sudden, severe pain and swelling.
- Psoriatic arthritis: A type of arthritis that occurs in some people with psoriasis, causing joint pain, stiffness, and swelling, including in the thumb.
- Sarcoidosis: A condition where inflammatory cells form lumps known as granulomas in various parts of the body, including the joints, which can cause pain and stiffness in the thumb.