Differential Diagnosis for Wrist Pain with "Clicky Noise"
- Single most likely diagnosis:
- De Quervain's tenosynovitis: This condition is characterized by inflammation of the tendons on the thumb side of the wrist, which can cause pain and a "clicking" or "snapping" sensation when moving the wrist or thumb. The patient's history of repetitive wrist motion while using a mouse and the presence of a "clicky noise" support this diagnosis.
- Other Likely diagnoses:
- Repetitive strain injury (RSI): The patient's recent increase in wrist pain with prolonged mouse use suggests an RSI, which can cause pain, stiffness, and swelling in the affected area.
- Ganglion cyst: A ganglion cyst is a non-cancerous lump that can develop on the wrist, causing pain, stiffness, and a "clicking" sensation.
- Wrist sprain or strain: The patient's history of self-harm by slamming their wrist/arm on a desk may have caused a sprain or strain, leading to ongoing pain and stiffness.
- Do Not Miss diagnoses:
- Fracture or osteonecrosis: Although less likely, it is essential to rule out a fracture or osteonecrosis, particularly given the patient's history of self-harm, as these conditions can have severe consequences if left untreated.
- Nerve compression or neuropathy: Conditions like carpal tunnel syndrome or radial nerve compression can cause wrist pain, numbness, and tingling, and can have significant consequences if not addressed.
- Rare diagnoses:
- Rheumatoid arthritis or other autoimmune disorders: Although less common, it is possible that the patient's wrist pain is related to an underlying autoimmune disorder, which would require further evaluation and treatment.
- Tendinous or ligamentous rupture: A rupture of a tendon or ligament in the wrist can cause severe pain and instability, and may require surgical intervention.