Differential Diagnosis for Acute Onset of Wrist Pain More with Extension
Single Most Likely Diagnosis
- Wrist Sprain: This is the most common cause of acute wrist pain, especially with activities that involve extension. The mechanism of injury often involves a fall onto an outstretched hand, leading to stretching or tearing of the ligaments around the wrist.
Other Likely Diagnoses
- Tennis Elbow (Lateral Epicondylitis): Although more commonly associated with activities involving gripping and twisting, the pain from tennis elbow can radiate to the wrist, especially with extension movements.
- Wrist Tendinitis: Inflammation of the tendons surrounding the wrist can cause pain, especially with movement. Extension of the wrist can exacerbate the pain if the tendons on the back of the wrist are involved.
- Ganglion Cyst: A lump or mass that can develop on the wrist, often causing pain, especially if it presses on a nerve or tendon. The pain can be exacerbated by certain movements, including extension.
Do Not Miss Diagnoses
- Scaphoid Fracture: A common fracture in the wrist that can occur from a fall onto an outstretched hand. It's crucial to diagnose early to prevent complications like avascular necrosis. The pain is typically worse with wrist extension and thumb movement.
- Infectious Arthritis: Bacterial or fungal infections within the wrist joint can cause severe pain, swelling, and decreased range of motion. This condition requires prompt diagnosis and treatment to prevent joint destruction.
- Gout or Pseudogout: These are forms of arthritis that can cause sudden, severe pain in the wrist, among other joints. While less common in the wrist compared to other joints, they are important to consider, especially in patients with a history of these conditions.
Rare Diagnoses
- Kienböck's Disease: A rare condition involving the collapse of the lunate bone in the wrist, leading to pain and limited motion. It's more common in young adults and can be associated with repetitive trauma or poor blood supply to the bone.
- Madelung's Deformity: A rare congenital condition affecting the wrist, characterized by a misshapen radius bone. It can cause pain and limited wrist motion, especially with extension, and is often diagnosed in adolescence or early adulthood.