Differential Diagnosis for Bilateral Wrist Pain

Single Most Likely Diagnosis

• Repetitive Strain Injury (RSI) or Overuse Syndrome: This is often the most common cause of bilateral wrist pain, especially in individuals who perform repetitive tasks with their hands and wrists, such as typing, using a computer mouse, or engaging in certain sports.

Other Likely Diagnoses

• Carpal Tunnel Syndrome: A condition that occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. Symptoms include numbness, tingling, and pain in the hand and wrist.
• Osteoarthritis: A type of arthritis characterized by the breakdown of cartilage in joints, leading to pain, stiffness, and limited mobility. It can affect any joint, including the wrists.
• Rheumatoid Arthritis: An autoimmune disorder that causes chronic inflammation and pain in the joints, often affecting the wrists bilaterally.
• Ganglion Cysts: Noncancerous lumps that can develop on the wrist, often causing pain, especially if they press on a nerve.

Do Not Miss Diagnoses

• Infectious Arthritis: A condition where the joint space becomes infected, leading to severe pain, swelling, and potential destruction of the joint if not promptly treated.
• Gout: A form of inflammatory arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness, often occurring at the base of the thumb or other joints.
• Pseudogout (Calcium Pyrophosphate Deposition Disease, CPPD): A type of arthritis that causes sudden, severe joint pain, similar to gout, but caused by calcium pyrophosphate dihydrate crystal deposition.
• Osteonecrosis (Avascular Necrosis): A condition that occurs when there is a loss of blood to the bone, leading to the death of bone tissue, which can cause wrist pain if it affects the bones in the wrist.

Rare Diagnoses

• Kienböck's Disease: A rare condition where the blood supply to the lunate bone in the wrist is disrupted, leading to the death of the bone tissue.
• Madelung's Deformity: A rare congenital condition affecting the wrist, characterized by a misshapen forearm bone (radius) and an abnormal wrist joint.
• Hemochromatosis: A genetic disorder characterized by excessive iron accumulation in the body, which can lead to joint pain, including in the wrists, due to iron deposition.
• Sarcoidosis: A condition where inflammatory cells form lumps known as granulomas in various parts of the body, including the joints, which can cause pain and stiffness in the wrists.