Differential Diagnosis for Unexplained Joint Swelling in Pregnancy
Single Most Likely Diagnosis
- Osteonecrosis: This condition, also known as avascular necrosis, can be precipitated by pregnancy due to increased pressure on joints and potential changes in blood clotting. It leads to joint pain and swelling, especially in weight-bearing joints, and can limit the range of motion.
Other Likely Diagnoses
- Pregnancy-Associated Osteoarthritis: Hormonal changes during pregnancy can lead to joint laxity and increased stress on joints, potentially exacerbating or triggering osteoarthritis symptoms.
- Septic Arthritis: Although less common, septic arthritis is a significant concern in pregnancy due to the immunocompromised state. It presents with sudden onset of joint pain, swelling, and limited range of motion, often with systemic signs of infection.
- Rheumatoid Arthritis (RA) Flare: Pregnancy can sometimes trigger the onset or flare of RA, leading to joint swelling, pain, and stiffness, particularly in the hands and feet.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Pregnancy increases the risk of DVT due to venous stasis and hypercoagulability. DVT can present with swelling, warmth, and pain in the affected limb, mimicking joint pathology.
- Osteomyelitis: Bone infection can occur in pregnancy and may present with localized pain, swelling, and limited mobility of the adjacent joint.
- Neoplastic Processes: Although rare, conditions like multiple myeloma or bone metastases can cause joint symptoms and should be considered, especially if there are systemic symptoms or an atypical presentation.
Rare Diagnoses
- Pregnancy-Associated Chondrolysis: A rare condition characterized by rapid destruction of articular cartilage, leading to severe joint pain and loss of function.
- Transient Osteoporosis of Pregnancy: A rare condition that typically affects the hip but can involve other joints, causing severe pain and limited mobility due to temporary osteoporosis.
- Relapsing Polychondritis: An autoimmune disorder that can cause cartilage inflammation, leading to joint pain and swelling, among other symptoms. It is rare and can be challenging to diagnose.