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Differential Diagnosis for Pain in Palm of Hand at Base of Thumb

Single Most Likely Diagnosis

  • De Quervain's Tenosynovitis: This condition, which affects the tendons on the thumb side of the wrist, is a common cause of pain at the base of the thumb, especially with gripping and hand activity. The pain is typically exacerbated by movements that involve twisting or turning of the wrist.

Other Likely Diagnoses

  • Thumb Carpometacarpal (CMC) Joint Arthritis: Osteoarthritis of the CMC joint can cause pain at the base of the thumb, particularly with gripping or pinching activities. This condition is more common in women and can lead to significant disability if not addressed.
  • Trigger Thumb: This condition involves the tendon sheath of the thumb, leading to pain and sometimes a palpable nodule at the base of the thumb. It can cause pain with gripping and may result in the thumb catching or locking.
  • Ganglion Cyst: A ganglion cyst is a benign lump that can form near the joints or tendons of the hand, including at the base of the thumb. While often painless, a cyst in this location could cause discomfort, especially with hand activity.

Do Not Miss Diagnoses

  • Giant Cell Tumor of the Tendon Sheath: Although rare, this tumor can present as a painful mass at the base of the thumb. It's crucial to consider this diagnosis to ensure timely treatment and prevent potential complications.
  • Infection (e.g., Septic Arthritis or Tenosynovitis): An infectious process in the thumb or wrist can cause severe pain, swelling, and redness. Early recognition and treatment are critical to prevent long-term damage.
  • Fracture or Ligament Injury: Trauma to the thumb or wrist can result in a fracture or ligament sprain, leading to pain at the base of the thumb. These conditions require prompt diagnosis and appropriate management to avoid complications.

Rare Diagnoses

  • Tumors of the Hand (e.g., Glomus Tumor): Various rare tumors can occur in the hand, including at the base of the thumb. These are often benign but can cause significant symptoms.
  • Nerve Compression (e.g., Superficial Branch of the Radial Nerve): Compression of nerves in the wrist or hand can lead to pain and other symptoms in the distribution of the affected nerve, including the base of the thumb.

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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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