Differential Diagnosis for Arthralgia, Muscle Pain, Harshness in Voice, and No Significant Fever

• Single Most Likely Diagnosis
  • Rheumatoid Arthritis (RA): This condition often presents with arthralgia (joint pain) and myalgia (muscle pain), and while it primarily affects the joints, systemic symptoms can include fatigue and occasionally, symptoms like hoarseness due to cricoarytenoid arthritis, a known but less common manifestation of RA.
• Other Likely Diagnoses
  • Polymyalgia Rheumatica (PMR): Characterized by aching and stiffness in the neck, shoulder, and hip areas, which could explain the muscle pain. Hoarseness could be a less common symptom, possibly related to inflammation affecting the laryngeal area indirectly.
  • Hypothyroidism: Can cause muscle pain, joint pain, and voice changes, including hoarseness. It's a relatively common condition that could explain these symptoms, especially in the absence of significant fever.
  • Viral Myositis: Certain viral infections can cause muscle inflammation leading to pain, and some viruses might also cause laryngitis, leading to voice changes.
• Do Not Miss Diagnoses
  • Laryngeal Cancer: Although less likely, it's crucial not to miss this diagnosis. Early symptoms can include hoarseness, and while it might not directly cause arthralgia or myalgia, these symptoms could be overlooked in the context of a more sinister underlying condition.
  • Relapsing Polychondritis: A rare autoimmune disorder that can cause cartilage inflammation, including that of the larynx and trachea, leading to voice changes, and it can also affect joints, causing arthralgia.
  • Sarcoidosis: Can cause a wide range of symptoms, including joint pain, muscle pain, and hoarseness if it affects the larynx. It's a diagnosis that could easily be missed but is critical due to its potential for serious complications.
• Rare Diagnoses
  • Dermatomyositis: An inflammatory disease characterized by skin rash and muscle weakness, which could potentially cause voice changes if the muscles used for speaking are affected.
  • Mixed Connective Tissue Disease (MCTD): Overlaps with lupus, scleroderma, and rheumatoid arthritis, and can cause a wide range of symptoms including arthralgia, myalgia, and potentially voice changes due to esophageal or laryngeal involvement.