Differential Diagnosis for Thumb and Thenar Eminence Pain
- Single most likely diagnosis
- Carpal Tunnel Syndrome: This condition is the most likely cause of thumb and thenar eminence pain due to the compression of the median nerve, which supplies sensation to the thumb and thenar muscles. Symptoms often include numbness, tingling, and pain in the thumb and the thenar eminence.
- Other Likely diagnoses
- De Quervain's Tenosynovitis: This condition affects the tendons on the thumb side of the wrist, leading to pain and tenderness, especially when forming a fist, grasping, or turning the wrist.
- Trigger Thumb: A condition where the thumb catches or locks when bent, often due to inflammation of the tendon sheath, causing pain and discomfort in the thumb.
- Thenar Muscle Strain: Overuse or direct injury to the muscles of the thenar eminence can cause pain and weakness in the thumb.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Median Nerve Injury: Direct trauma to the median nerve can cause severe and potentially permanent damage, leading to loss of sensation and motor function in the thumb and other parts of the hand.
- Infection (e.g., Paronychia, Cellulitis): Infections in the hand can spread rapidly and lead to serious complications, including abscess formation, osteomyelitis, or even sepsis.
- Ganglion Cyst: Although usually benign, a ganglion cyst near the wrist or thumb can cause pain and may lead to nerve compression if it compresses nearby nerves.
- Rare diagnoses
- Gout or Pseudogout: These conditions can cause sudden, severe pain in the joints, including those in the thumb, although they are less common causes of isolated thumb and thenar eminence pain.
- Tumors (e.g., Giant Cell Tumor of the Tendon Sheath): Rare benign tumors can occur in the hand and cause localized pain and swelling.
- Sarcoidosis: A systemic disease that can cause granulomatous inflammation in various parts of the body, including the hands, leading to pain and swelling.