Differential Diagnosis for 21 y/o Female with Bilateral Wrist Pain and General Weakness
- The patient's symptoms of bilateral wrist pain and general weakness, despite physical therapy, suggest a range of potential diagnoses.
Single Most Likely Diagnosis
- Rheumatoid Arthritis (RA): This is a common autoimmune disorder that can cause bilateral wrist pain, swelling, and stiffness, as well as general weakness and fatigue. The patient's age and the fact that symptoms have persisted despite physical therapy make RA a likely consideration.
Other Likely Diagnoses
- Osteoporosis: Although less common in young adults, osteoporosis can cause wrist pain and weakness, particularly if there is a family history or other risk factors such as poor nutrition or hormonal imbalances.
- Repetitive Strain Injury (RSI): This condition can cause wrist pain and weakness, especially if the patient has a job or engages in activities that involve repetitive arm or hand movements.
- Hypothyarmia: This condition, which involves an underactive thyroid gland, can cause muscle weakness, fatigue, and joint pain, including wrist pain.
Do Not Miss Diagnoses
- Multiple Myeloma: This type of cancer can cause bone pain, including wrist pain, as well as general weakness and fatigue. Although it is relatively rare, especially in young adults, it is a critical diagnosis to consider due to its potential severity.
- Osteogenesis Imperboim (OI): This genetic disorder can cause brittle bones, leading to fractures and wrist pain, as well as other skeletal deformities.
- Amyotrophic Lateral Sclerosis (ALS): This progressive neurological disease can cause muscle weakness, including in the wrists, as well as general fatigue and weakness.
Rare Diagnoses
- Ehlers-Danlos Syndrome: This group of genetic disorders can cause joint hypermobility, skin hyperextensibility, and tissue fragility, leading to wrist pain and weakness.
- Stickler Syndrome: This genetic disorder can cause skeletal abnormalities, including wrist pain and weakness, as well as eye and hearing problems.
- Mixed Connective Tissue Disease: This autoimmune disorder can cause a combination of symptoms, including wrist pain and weakness, as well as other systemic symptoms such as fever and fatigue.