Differential Diagnosis for Unilateral Cold Painful Hand

• Single most likely diagnosis
  • Raynaud's phenomenon: This condition is characterized by a sudden and temporary narrowing of the arteries, leading to reduced blood flow to the fingers and toes. It is often triggered by cold temperatures or stress, causing the hands to become cold, discolored, and painful.
• Other Likely diagnoses
  • Peripheral artery disease (PAD): This condition involves the narrowing or blockage of the blood vessels outside of the heart, leading to reduced blood flow to the limbs. It can cause coldness, pain, and weakness in the affected hand.
  • Thoracic outlet syndrome: This condition involves compression of the nerves and/or blood vessels that pass through the thoracic outlet (the space between the collarbone and first rib). It can cause pain, numbness, and coldness in the affected hand.
  • Carpal tunnel syndrome: This condition involves compression of the median nerve as it passes through the wrist. It can cause pain, numbness, and tingling in the hand, especially in the thumb, index, and middle fingers.
• Do Not Miss diagnoses
  • Acute arterial occlusion: This is a medical emergency that occurs when there is a sudden blockage of a blood vessel, leading to severe pain, coldness, and numbness in the affected hand. It requires immediate medical attention to prevent tissue damage and loss of function.
  • Embolic event: This occurs when a blood clot or other foreign material travels through the bloodstream and lodges in a blood vessel, causing a blockage. It can lead to severe pain, coldness, and numbness in the affected hand.
• Rare diagnoses
  • Buerger's disease: This is a rare condition that involves inflammation and blockage of the blood vessels, leading to reduced blood flow to the limbs. It can cause coldness, pain, and weakness in the affected hand.
  • Cryoglobulinemia: This is a rare condition that involves the presence of abnormal proteins in the blood that can cause blood vessels to narrow and reduce blood flow to the limbs. It can cause coldness, pain, and numbness in the affected hand.
  • Erythromelalgia: This is a rare condition that involves burning pain, heat, and redness in the hands and feet. It can be caused by a variety of factors, including genetic mutations and certain medications.