What is the cause of lateral elbow and upper forearm pain with numbness and tingling in the fourth (ring) and fifth (pinky) fingers during downward extension of the hand?

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Differential Diagnosis for Lateral Elbow and Upper Forearm Pain with Numbness and Tingling

  • Single most likely diagnosis:
    • Cubital Tunnel Syndrome: This condition is characterized by compression of the ulnar nerve at the elbow, leading to pain in the lateral elbow and upper forearm, numbness, and tingling in the pinky and ring fingers, especially when the hand is extended downward.
  • Other Likely diagnoses:
    • Lateral Epicondylitis (Tennis Elbow): Although it primarily causes pain on the lateral aspect of the elbow, it can sometimes radiate down the forearm and may cause numbness or tingling if the radial nerve is irritated.
    • Radial Tunnel Syndrome: This involves compression of the radial nerve, which can cause pain in the back of the hand and the forearm, but less commonly associated with numbness and tingling in the pinky and ring fingers.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Acute Compartment Syndrome: A medical emergency that can cause severe pain, numbness, and tingling due to increased pressure within the compartments of the forearm. It requires immediate attention to prevent permanent damage.
    • Cervical Radiculopathy: Although less likely, nerve root compression in the cervical spine can cause symptoms in the arm and hand, including pain, numbness, and tingling. It's crucial to consider this diagnosis to rule out a more serious spinal condition.
  • Rare diagnoses:
    • Thoracic Outlet Syndrome: This condition involves compression of the nerves and/or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib). It can cause pain in the neck and shoulder, and sometimes down the arm, but is less commonly associated with the specific symptoms described.
    • Peripheral Neuropathy: Various forms of peripheral neuropathy can cause numbness, tingling, and pain in the hands and feet, but it would be unusual for it to present with such localized symptoms as described in the question.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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