Differential Diagnosis for Swelling of Soft Tissue on Hand with History of Gout
Single Most Likely Diagnosis
- Gouty tophus: Given the patient's history of gout, a gouty tophus is a likely cause of soft tissue swelling on the hand. Gouty tophi are deposits of monosodium urate crystals that can accumulate in the soft tissues, especially in patients with chronic gout.
Other Likely Diagnoses
- Cellulitis: An infection of the skin and soft tissues, cellulitis can cause swelling, redness, and warmth in the affected area. It's a common condition that can occur on the hand.
- Abscess: A localized collection of pus, an abscess can cause swelling and may be accompanied by signs of infection such as redness, warmth, and pain.
- Rheumatoid nodule: Although less common than gouty tophi in this context, rheumatoid nodules can occur in patients with rheumatoid arthritis and cause soft tissue swelling.
Do Not Miss Diagnoses
- Septic arthritis: Although the primary complaint is soft tissue swelling, it's crucial to consider septic arthritis, especially if the swelling is near a joint. Septic arthritis is a medical emergency that requires prompt treatment to prevent joint destruction.
- Osteomyelitis: An infection of the bone, osteomyelitis can cause swelling and pain in the affected area. It's a serious condition that requires early diagnosis and treatment.
- Necrotizing fasciitis: A severe infection of the fascia, necrotizing fasciitis is a life-threatening condition that can cause swelling, pain, and skin changes. It requires immediate medical attention.
Rare Diagnoses
- Sarcoidosis: A condition characterized by the growth of granulomas in various parts of the body, sarcoidosis can cause soft tissue swelling, although it's less common in the hand.
- Amyloidosis: The deposition of amyloid proteins can cause soft tissue masses, although this is a rare condition and would be unusual as a primary presentation on the hand.
- Soft tissue tumor: Various types of soft tissue tumors (benign or malignant) can cause swelling on the hand, but these are relatively rare compared to other causes of soft tissue swelling.