Differential Diagnosis for Thumb/Wrist Pain with Cyst-like Lesion in a 60-year-old Female
- Single most likely diagnosis
- Ganglion cyst: This is the most common benign tumor of the hand and wrist, often presenting as a cyst-like lesion. The patient's age and the description of the lesion make this a highly plausible diagnosis.
- Other Likely diagnoses
- Rheumatoid arthritis: This chronic autoimmune disorder can cause wrist and thumb pain, and while less likely to present as a cyst, it's a common condition in this age group that could have various manifestations.
- Osteoarthritis: Similar to rheumatoid arthritis, osteoarthritis can cause pain in the wrist and thumb, especially in older adults, and might be associated with cystic changes like ganglion cysts.
- De Quervain's tenosynovitis: This condition affects the tendons on the thumb side of your wrist and can cause pain and swelling, which might be mistaken for a cyst.
- Do Not Miss diagnoses
- Infection (e.g., abscess or cellulitis): Although less likely, an infectious process could present with swelling and pain, and missing this diagnosis could lead to serious complications.
- Gout: While typically associated with the big toe, gout can affect any joint, including those in the wrist and thumb, and can cause sudden, severe pain.
- Bone or soft tissue tumor (malignant): Although rare, a malignant tumor could present as a cyst-like lesion, and missing this diagnosis would have significant consequences.
- Rare diagnoses
- Giant cell tumor of the tendon sheath: A rare, benign tumor that could present similarly to a ganglion cyst but is less common.
- Epidermoid cyst: A benign cyst that could occur in the wrist or thumb but is less common than a ganglion cyst.
- Sarcoidosis: A systemic disease that can cause cyst-like lesions in the hands, among other symptoms, but is relatively rare.