Palmar Pain Differential Diagnosis
The following is a differential diagnosis for palmar pain, categorized for clarity and emphasis on critical conditions.
- Single Most Likely Diagnosis
- Dupuytren's Contracture: A common condition characterized by the thickening of the palmar fascia, leading to nodules and cord formation that can cause pain and flexion deformity of the fingers. It's a likely diagnosis due to its prevalence and the nature of the symptoms.
- Other Likely Diagnoses
- Carpal Tunnel Syndrome: This condition involves the compression of the median nerve as it passes through the wrist, leading to pain, numbness, and tingling in the hand, particularly affecting the thumb, index, and middle fingers.
- Palmar Fasciitis: Inflammation of the palmar fascia can cause pain and stiffness in the palm, often associated with activities that strain the hand.
- Ganglion Cysts: These are non-cancerous lumps that can develop on the wrist or hand, sometimes causing pain, especially if they press on a nerve.
- Do Not Miss Diagnoses
- Infections (e.g., Paronychia, Felon): Infections of the hand or fingers can be severe and require prompt treatment to prevent serious complications like abscess formation or spread of infection.
- Deep Vein Thrombosis (DVT) of the Hand: Although rare, DVT in the hand can occur and is a medical emergency due to the risk of pulmonary embolism.
- Compartment Syndrome: Increased pressure within the compartments of the hand can lead to severe pain, numbness, and potentially permanent damage if not treated promptly.
- Rare Diagnoses
- Glomus Tumor: A rare, benign tumor of the glomus body that can cause significant pain, often localized to a specific area of the hand or finger.
- Erythromelalgia: A disorder characterized by burning pain, heat, and redness in the hands and feet, which can be primary or secondary to other conditions.
- Sarcoidosis: A systemic disease that can rarely cause hand pain due to granulomatous inflammation in the bones or soft tissues of the hand.
Each diagnosis has a brief justification based on the nature of palmar pain and the potential causes, ranging from common conditions like Dupuytren's contracture to rare but critical diagnoses that must not be missed due to their potential for severe outcomes.