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Differential Diagnosis for Dorsal Central Wrist Pain

Single Most Likely Diagnosis

  • Wrist Extensor Tendinopathy: This condition, often related to overuse or repetitive strain, is a common cause of dorsal wrist pain, especially if it started with activities like pushups that involve wrist extension. The pain's progression from being activity-related to being present at rest suggests an inflammatory component.

Other Likely Diagnoses

  • Ganglion Cyst: A common benign tumor that can cause dorsal wrist pain, especially if it compresses nearby nerves or tendons. The pain can be constant and may not necessarily be related to activity.
  • Scapholunate Ligament Injury: An injury to this ligament can cause dorsal wrist pain, especially with activities that involve wrist extension or rotation. The pain may persist at rest if the injury leads to instability or inflammation.
  • Wrist Synovitis: Inflammation of the synovial lining of the wrist joint can cause pain, swelling, and stiffness, including dorsal wrist pain that may be present at rest.

Do Not Miss Diagnoses

  • Infectious Arthritis: Although less common, infectious arthritis of the wrist can cause severe pain, swelling, and redness. It is crucial to consider this diagnosis to initiate prompt antibiotic treatment and prevent long-term joint damage.
  • Gout or Pseudogout: These conditions can cause sudden, severe wrist pain and should be considered, especially if there are risk factors or a history of similar episodes.
  • Osteonecrosis of the Wrist Bones: A condition where the blood supply to one of the wrist bones (e.g., the lunate in Kienböck's disease) is compromised, leading to bone death. It can cause chronic wrist pain and should be considered to prevent further bone collapse.

Rare Diagnoses

  • Kienböck's Disease: A rare condition characterized by the collapse of the lunate bone due to a loss of blood supply, leading to chronic wrist pain.
  • Madelung's Deformity: A rare congenital condition that affects the distal radius and ulna, potentially causing wrist pain and deformity.
  • Tumor of the Wrist: Although rare, primary or metastatic tumors can occur in the wrist, causing pain, swelling, and other symptoms.

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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