Differential Diagnosis for Multiple Joint Swelling during Pregnancy with Pain

• Single Most Likely Diagnosis
  • Osteoarthritis: Although not exclusive to pregnancy, the increased weight and altered biomechanics during pregnancy can exacerbate osteoarthritis symptoms, leading to joint swelling and pain.
• Other Likely Diagnoses
  • Rheumatoid Arthritis (RA): RA can be triggered or worsened by pregnancy due to hormonal changes. It causes symmetric joint pain and swelling, often affecting hands and feet.
  • Psoriatic Arthritis: This condition can also be triggered or exacerbated by pregnancy, leading to joint pain, swelling, and skin psoriasis.
  • Lupus: Systemic lupus erythematosus can cause joint pain and swelling and is known to have a complex relationship with pregnancy, sometimes improving but often worsening.
• Do Not Miss Diagnoses
  • Septic Arthritis: Although rare, septic arthritis is a medical emergency that requires prompt diagnosis and treatment. Pregnancy increases the risk of certain infections due to immune system modulation.
  • Osteonecrosis: This condition, also known as avascular necrosis, can be precipitated by corticosteroid use (sometimes used in pregnancy for various conditions) and leads to severe joint pain.
• Rare Diagnoses
  • Relapsing Polychondritis: A rare autoimmune disorder that can cause cartilage inflammation, leading to joint pain and swelling, among other symptoms.
  • Ehlers-Danlos Syndrome: A group of genetic disorders affecting connective tissues, which can lead to joint hypermobility and pain, potentially exacerbated by pregnancy.