Differential Diagnosis for Base of Thumb Pain
- Single most likely diagnosis
- Osteoarthritis of the first carpometacarpal joint: This is the most common cause of base of thumb pain, especially in older adults. The first carpometacarpal joint is prone to wear and tear, leading to osteoarthritis, which causes pain and stiffness.
- Other Likely diagnoses
- De Quervain's tenosynovitis: This condition involves inflammation of the tendons on the thumb side of the wrist, leading to pain and tenderness, especially when forming a fist or grasping.
- Thumb sprain: A sprain of the ligaments surrounding the base of the thumb can cause pain and instability.
- Ganglion cyst: A benign cyst that can develop near the base of the thumb, causing pain and discomfort.
- Do Not Miss diagnoses
- Scaphoid fracture: A fracture of the scaphoid bone in the wrist can cause pain at the base of the thumb and is often missed on initial X-rays.
- Infection (e.g., septic arthritis or osteomyelitis): Infections in the joint or bone can cause severe pain and require prompt treatment to avoid serious complications.
- Tumor (e.g., giant cell tumor of the tendon sheath): Although rare, tumors can cause base of thumb pain and should not be missed.
- Rare diagnoses
- Rheumatoid arthritis: Although more common in other joints, rheumatoid arthritis can affect the base of the thumb, causing pain and stiffness.
- Gout: Gout can cause sudden, severe pain and swelling in the base of the thumb, especially in individuals with a history of gout.
- Psoriatic arthritis: This condition can cause pain and stiffness in the base of the thumb, especially in individuals with psoriasis.