Differential Diagnosis

• Single most likely diagnosis:
  • De Quervain's tenosynovitis: This condition is characterized by pain and tenderness on the radial side of the wrist, particularly at the anatomical snuffbox and the base of the thumb, which matches the patient's symptoms. The positive Finkelstein's test also supports this diagnosis, as it is a specific test for De Quervain's tenosynovitis.
• Other Likely diagnoses:
  • Wrist strain or sprain: Given the patient's history of lifting a baby and experiencing pain when doing so, a strain or sprain of the wrist is a plausible diagnosis. However, the specific location of the pain and the positive Finkelstein's test make De Quervain's tenosynovitis more likely.
  • Carpal tunnel syndrome: The patient reports tingling in the thumb and fingers, which could suggest carpal tunnel syndrome. However, the absence of pain at the interphalangeal joints and the specific location of the pain on the radial side of the wrist make this diagnosis less likely.
• Do Not Miss diagnoses:
  • Scaphoid fracture: Although the patient does not report a specific traumatic event, a scaphoid fracture could present with pain on the radial side of the wrist and should be considered to avoid missing a potentially serious condition.
  • Osteonecrosis of the lunate (Kienböck's disease): This condition could present with wrist pain and should be considered, especially if the patient has a history of trauma or repetitive stress on the wrist.
• Rare diagnoses:
  • Ganglion cyst: A ganglion cyst could cause pain and tenderness on the radial side of the wrist but is less likely given the patient's symptoms and the positive Finkelstein's test.
  • Rheumatoid arthritis: Although rheumatoid arthritis could cause wrist pain, it typically presents with symmetric joint involvement and other systemic symptoms, making it a less likely diagnosis in this case.