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Differential Diagnosis for Sudden Onset of Pain from Shoulder to Hand with Puffiness on Forearm in a Young Female

  • Single Most Likely Diagnosis
    • Acute Compartment Syndrome: This condition is characterized by increased pressure within a muscle compartment, leading to pain, swelling, and potentially, nerve and muscle damage. The sudden onset of pain from the shoulder to the hand, along with puffiness on the forearm, could indicate increased pressure within the compartments of the forearm or arm.
  • Other Likely Diagnoses
    • Deep Vein Thrombosis (DVT): Although less common in young females without risk factors, DVT can cause swelling and pain in the arm. The pain can radiate from the shoulder down to the hand if the clot affects blood flow significantly.
    • Thoracic Outlet Syndrome: This condition involves compression of the nerves and/or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib). It can cause pain in your shoulders and neck and numbness in your fingers.
    • Radial or Ulnar Nerve Compression: Compression of these nerves can cause pain, numbness, and tingling from the elbow down to the hand, depending on which nerve is affected.
  • Do Not Miss Diagnoses
    • Pulmonary Embolism (if associated with shortness of breath or chest pain): Although the primary symptoms are in the arm, if there are any respiratory symptoms, pulmonary embolism must be considered due to its high mortality rate if untreated.
    • Arterial Occlusion: A blockage in one of the arteries supplying blood to the arm can cause severe pain, pallor, pulselessness, poikilothermia, paresthesias, and paralysis. This is a medical emergency.
  • Rare Diagnoses
    • Vasculitis: Inflammation of the blood vessels can cause a wide range of symptoms, including pain and swelling in the affected limb.
    • Complex Regional Pain Syndrome (CRPS): A condition characterized by persistent burning pain and certain abnormalities that occur after an injury to a bone and/or soft tissue, which can cause swelling and changes in skin temperature and color.
    • Neoplastic Conditions: Tumors affecting the nerves or blood vessels of the arm can cause pain and swelling, though these would be less common and typically have a more gradual onset.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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