Differential Diagnosis for Hand Swelling in the Morning
Single Most Likely Diagnosis
- Rheumatoid Arthritis (RA): Morning hand swelling is a common symptom of RA, an autoimmune disorder that causes inflammation and pain in the joints. The swelling is often accompanied by stiffness and can significantly impact daily activities.
Other Likely Diagnoses
- Osteoarthritis: Although more commonly associated with wear and tear, osteoarthritis can cause morning stiffness and swelling, especially in the hands, due to inflammation and fluid accumulation overnight.
- Gout: Gouty arthritis can cause sudden, severe swelling and pain in the hands, especially after periods of rest or at night, due to urate crystal deposition.
- Psoriatic Arthritis: This condition combines the swollen, scaly skin of psoriasis with joint pain and arthritis, which can include morning hand swelling.
Do Not Miss Diagnoses
- Infection (e.g., Cellulitis or Abscess): Infections can cause rapid swelling, redness, and warmth, and it's crucial to identify and treat them promptly to avoid serious complications.
- Deep Vein Thrombosis (DVT): Although less common in the hands, DVT can cause swelling and should be considered, especially if there's a history of clotting disorders or recent immobility.
- Compartment Syndrome: A medical emergency where increased pressure within a muscle compartment can lead to nerve and muscle damage, characterized by severe pain, swelling, and sometimes pallor or paresthesia.
Rare Diagnoses
- Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the hands, leading to swelling and other symptoms.
- Amyloidosis: A group of diseases that can cause abnormal protein deposits in various organs, including the hands, leading to swelling among other symptoms.
- Hematologic Disorders (e.g., Hemophilia): Certain bleeding disorders can lead to joint swelling due to hemorrhage into the joint space, though hand involvement is less common than larger joints.