Differential Diagnosis for a 38-year-old man with pain and inability to extend his middle finger DIP joint
- Single most likely diagnosis
- Mallet finger: This is the most likely diagnosis given the mechanism of injury (jamming-type injury) and the presentation of pain and inability to extend the DIP joint. Mallet finger typically occurs when the extensor tendon is stretched or torn, leading to an inability to extend the DIP joint.
- Other Likely diagnoses
- Volar plate injury: A volar plate injury could also occur with a jamming-type injury, leading to pain and stiffness in the DIP joint.
- Distal phalanx fracture (non-displaced): Although the radiographs are normal, a non-displaced fracture could still be present, causing pain and limited mobility.
- Extensor tendon rupture: A rupture of the extensor tendon could also lead to an inability to extend the DIP joint.
- Do Not Miss diagnoses
- Infection (e.g., septic arthritis): Although unlikely, an infection could present with pain and limited mobility, and would require prompt treatment to avoid serious complications.
- Osteonecrosis: Osteonecrosis of the distal phalanx could occur due to trauma, and would require prompt diagnosis and treatment to avoid long-term damage.
- Rare diagnoses
- Tumor (e.g., osteochondroma): A tumor could cause pain and limited mobility in the DIP joint, although this would be a rare cause of acute symptoms following a traumatic injury.
- Rheumatologic condition (e.g., psoriatic arthritis): A rheumatologic condition could cause pain and stiffness in the DIP joint, although this would be an unusual presentation for such a condition.