Differential Diagnosis for Left Wrist Pain
Single Most Likely Diagnosis
- Radial Styloid Tenosynovitis or De Quervain's Tenosynovitis: This condition is characterized by inflammation of the tendons on the thumb side of the wrist, which can be exacerbated by activities that involve gripping or twisting, such as pushing up off a cough. The tenderness near the radial pulse and limited range of motion are consistent with this diagnosis.
Other Likely Diagnoses
- Wrist Sprain: A sprain could occur from the sudden movement of pushing up, especially if the wrist was in an awkward position. The pain and limited range of motion could be indicative of a sprain.
- Radial Head or Neck Fracture: Although less common, a fracture in this area could cause pain near the radial pulse and limit wrist motion, especially if the fracture occurred during the coughing episode.
- Ganglion Cyst: These are common benign lumps that can cause pain and limited mobility, especially if they are located near the wrist joint.
Do Not Miss Diagnoses
- Scaphoid Fracture: This is a potentially serious injury that could result from a fall onto an outstretched hand or a sudden, forceful movement like pushing up from a cough. Missing a scaphoid fracture could lead to complications like avascular necrosis.
- Radial Artery Injury or Thrombosis: Although rare, an injury to the radial artery could occur from trauma and might present with pain, limited mobility, and potentially diminished pulses.
- Infection (e.g., Septic Arthritis): An infection in the wrist joint could cause severe pain, limited range of motion, and tenderness. This condition requires prompt medical attention to avoid serious complications.
Rare Diagnoses
- Kienböck's Disease: A rare condition characterized by the collapse of the lunate bone in the wrist, which could cause chronic pain and limited wrist motion.
- Gout or Pseudogout: These conditions involve the deposition of crystals within the joints and can cause sudden, severe pain and limited mobility. They are less common in the wrist but should be considered in the differential diagnosis, especially in patients with a history of these conditions.