Differential Diagnosis for First Phalangophalangeal Joint Swelling
Single Most Likely Diagnosis
- Osteoarthritis (OA): This is the most common cause of joint swelling and pain in the first phalangophalangeal joint, especially in older adults. OA leads to cartilage breakdown and bone-on-bone contact, causing pain, stiffness, and swelling.
Other Likely Diagnoses
- Rheumatoid Arthritis (RA): An autoimmune disorder that can cause symmetric joint inflammation, including the first phalangophalangeal joint. Morning stiffness and systemic symptoms may accompany joint swelling.
- Gout: A form of inflammatory arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness, often affecting the first phalangophalangeal joint.
- Trauma or Injury: Direct blows or strains to the joint can cause swelling due to inflammation or hemorrhage.
- Septic Arthritis: A bacterial or fungal infection within the joint, which is a medical emergency requiring prompt treatment.
Do Not Miss Diagnoses
- Septic Arthritis: Although mentioned earlier, it's crucial to reiterate due to its potential for severe consequences, including joint destruction and systemic infection, if not promptly treated.
- Lyme Arthritis: Caused by the bacterium Borrelia burgdorferi, transmitted by tick bites. It can cause intermittent swelling of joints, including the first phalangophalangeal joint.
- Psoriatic Arthritis: A type of arthritis that occurs in some people with psoriasis, causing joint pain, swelling, and stiffness, which can be asymmetric and affect any joint, including the first phalangophalangeal joint.
Rare Diagnoses
- Hemochromatosis: A genetic disorder causing excessive iron accumulation, which can lead to OA-like symptoms in joints, including the first phalangophalangeal joint, due to iron deposition.
- Charcot-Marie-Tooth Disease: A group of inherited disorders that affect the peripheral nerves, potentially causing joint deformities and swelling due to muscle imbalance and altered gait.
- Sarcoidosis: A condition in which inflammatory cells (granulomas) form in various parts of the body, including joints, leading to swelling and pain, though less commonly affecting the first phalangophalangeal joint.