Differential Diagnosis for Bilateral Wrist Pain
Single Most Likely Diagnosis
- Repetitive Strain Injury (RSI): This is a common condition that affects individuals who perform repetitive tasks, such as typing or using a computer mouse, leading to strain on the wrists. The bilateral nature of the pain and its association with repetitive activities make RSI a likely diagnosis.
Other Likely Diagnoses
- Osteoarthritis: A degenerative joint disease that can affect the wrists, causing pain and stiffness. Bilateral involvement is common, especially in older adults.
- Rheumatoid Arthritis: An autoimmune disease that can cause inflammation and pain in multiple joints, including the wrists. Bilateral wrist pain is a hallmark of this condition.
- Carpal Tunnel Syndrome: A condition that occurs when the median nerve is compressed at the wrist, leading to pain, numbness, and tingling. It can occur bilaterally, especially in individuals with risk factors such as diabetes or thyroid disease.
Do Not Miss Diagnoses
- Gout: A form of arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness. Although less common in the wrists, gout can cause bilateral wrist pain and must be considered to avoid missing this potentially treatable condition.
- Infection (e.g., Septic Arthritis): Infections within the joint can cause severe pain, swelling, and redness. Bilateral septic arthritis is rare but can occur, especially in immunocompromised individuals, and requires prompt diagnosis and treatment to prevent serious complications.
- Cancer (e.g., Metastatic Bone Disease): Although rare, cancer can cause bilateral wrist pain, especially if the cancer has metastasized to the bones of the wrists.
Rare Diagnoses
- Kienböck's Disease: A rare condition characterized by the collapse of the lunate bone in the wrist, leading to pain and limited motion. It typically affects one wrist but can be bilateral in rare cases.
- Ganglion Cysts: Non-cancerous lumps that can develop on the wrist, causing pain and discomfort. While usually unilateral, ganglion cysts can occasionally occur bilaterally.
- Scleroderma: A chronic autoimmune disease that can cause thickening of the skin and inflammation of various tissues, including the joints. Bilateral wrist pain can be a feature of this condition, although it is relatively rare.