Differential Diagnosis for 17-year-old with R hand pain
- Single most likely diagnosis
- Compartment syndrome: This is the most likely diagnosis given the history of trauma (dropping a heavy muffler on the hand) followed by pain, swelling, and tingling. These symptoms, especially occurring after a repair of a laceration, suggest increased pressure within the compartments of the hand, which is a hallmark of compartment syndrome.
- Other Likely diagnoses
- Infection (e.g., cellulitis or abscess): Given the recent history of a laceration that was repaired, there's a risk of infection, which could cause pain, swelling, and possibly tingling if it involves nerve irritation.
- Nerve injury: The trauma could have directly injured nerves in the hand, leading to tingling and pain.
- Fracture: Although not explicitly mentioned, the mechanism of injury (dropping a heavy object on the hand) could potentially cause a fracture, which would explain the pain and swelling.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Vascular injury: An injury to the blood vessels could lead to ischemia or gangrene if not promptly addressed. The symptoms of pain, swelling, and tingling could be indicative of compromised blood flow.
- Osteomyelitis: Although less common in the acute setting of a trauma, if the laceration became infected and the infection spread to the bone, osteomyelitis could occur, which is a serious condition requiring prompt treatment.
- Rare diagnoses
- Complex regional pain syndrome (CRPS): This is a rare condition characterized by intense burning or aching pain in the hands or feet after an injury. The tingling and swelling could be part of CRPS, but it's less likely given the acute presentation.
- Raynaud’s phenomenon: This condition affects blood flow to the fingers and toes, and sometimes the ears, nose, and lips, causing them to turn blue and feel cold and painful. While it could explain some symptoms, it's less directly related to the trauma described.