Differential Diagnosis for Monoarticular Joint Pain
Single Most Likely Diagnosis
- Osteoarthritis (OA): The most common cause of monoarticular joint pain, especially in older adults, due to wear and tear of the joint cartilage.
Other Likely Diagnoses
- Gout: A form of inflammatory arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one joint, often the big toe.
- Septic arthritis: A painful infection in a joint, usually caused by bacteria, but sometimes by viruses or fungi, which can lead to severe joint damage if not promptly treated.
- Traumatic injury: Fractures, sprains, or ligament tears can cause monoarticular joint pain, depending on the severity and location of the injury.
- Meniscal tear: A common knee injury that can cause pain, locking, or catching sensation in the knee joint.
Do Not Miss Diagnoses
- Septic arthritis (mentioned earlier, but crucial to emphasize due to its potential for severe consequences if missed): Prompt diagnosis and treatment are essential to prevent joint destruction and systemic complications.
- Lyme arthritis: A late manifestation of Lyme disease, causing intermittent or persistent arthritis, usually in the knee, which can be missed if not considered in endemic areas or with appropriate exposure history.
- Tuberculous arthritis: A rare but serious form of arthritis caused by Mycobacterium tuberculosis, which can mimic other forms of arthritis but requires specific treatment to prevent long-term damage.
Rare Diagnoses
- Pseudogout (Calcium Pyrophosphate Deposition Disease, CPPD): A type of arthritis that causes sudden, severe joint pain, similar to gout, but caused by calcium pyrophosphate dihydrate crystals.
- Hemarthrosis: Bleeding into the joint space, which can be due to trauma, bleeding disorders, or anticoagulant therapy, and can lead to severe joint pain and swelling.
- Charcot joint (Neuropathic arthropathy): A condition characterized by progressive degeneration of a joint due to nerve damage, often seen in diabetes or other conditions affecting nerve supply.
- Synovial chondromatosis: A rare condition where cartilage grows inside the synovium of a joint, leading to joint pain, swelling, and locking.