Differential Diagnosis for Left Wrist Swollen and Tender Overnight
- Single Most Likely Diagnosis
- Gout: This is a common condition characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, most often the big toe, but can also affect the wrist. The acute onset of symptoms overnight fits the typical presentation of gout.
- Other Likely Diagnoses
- Trauma (sprain or fracture): An injury to the wrist could cause swelling and tenderness, especially if it occurred recently and the patient is now presenting with symptoms.
- Infection (septic arthritis): Bacterial or fungal infections can cause joint inflammation, leading to swelling, tenderness, and pain. This condition requires prompt medical attention.
- Rheumatoid Arthritis (RA) flare: For patients with a history of RA, a flare can cause sudden worsening of symptoms in any joint, including the wrist.
- Pseudogout (Calcium Pyrophosphate Deposition Disease, CPPD): Similar to gout, pseudogout causes sudden, severe joint pain and swelling, often in larger joints like the knee but can also affect the wrist.
- Do Not Miss Diagnoses
- Septic arthritis: Although mentioned under other likely diagnoses, it's crucial to emphasize the importance of not missing this condition due to its potential for rapid joint destruction and systemic infection.
- Osteomyelitis: An infection of the bone that can spread from adjacent soft tissue or via the bloodstream, requiring early diagnosis and treatment to prevent serious complications.
- Compartment syndrome: A condition resulting from increased pressure within a muscle compartment, which can lead to muscle and nerve damage. It's a medical emergency.
- Rare Diagnoses
- Hemarthrosis: Bleeding into the joint space, which could be due to trauma, bleeding disorders, or anticoagulant therapy.
- Neuropathic arthropathy (Charcot joint): A condition resulting from repeated trauma, progressive degeneration of a weight-bearing joint, and loss of sensation, often seen in patients with diabetes or other neuropathic conditions.
- Sarcoidosis: A systemic disease that can cause inflammation in various parts of the body, including the joints, though wrist involvement is less common.
- Tumor or cyst (e.g., ganglion cyst): Although less likely to cause acute swelling and tenderness overnight, these should be considered in the differential diagnosis, especially if other causes are ruled out.