What is the diagnosis for left elbow pain and swelling 3 days post-trauma, with mild increased warmth, tenderness to palpation, and limited extension, in a patient with a history of gout (gouty arthritis)?

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Differential Diagnosis for Elbow Pain and Swelling

Single Most Likely Diagnosis

  • Elbow Fracture or Sprain: Given the recent fall and inability to straighten the elbow, a fracture or sprain is highly likely. The pain, swelling, and mildly increased warmth are consistent with this diagnosis.

Other Likely Diagnoses

  • Olecranon Bursitis: The increased warmth and pain to palpation could suggest olecranon bursitis, especially if the fall caused direct trauma to the elbow. This condition is characterized by inflammation of the bursa at the back of the elbow.
  • Elbow Contusion or Hematoma: A contusion or hematoma could also explain the pain, swelling, and warmth, especially if there was significant trauma to the area.
  • Radial Head Fracture: A fracture of the radial head could cause pain and limited mobility in the elbow, especially with rotation and extension.

Do Not Miss Diagnoses

  • Septic Arthritis: Although less likely, septic arthritis is a serious condition that requires prompt diagnosis and treatment. The increased warmth and pain could be indicative of an infection, especially if the patient has a history of joint problems or is immunocompromised.
  • Compartment Syndrome: This is a medical emergency that can occur after a fracture or severe trauma, causing increased pressure within the muscle compartments. It is essential to consider this diagnosis, especially if the patient reports severe pain, pallor, poikilothermia, paresthesia, or pulselessness.

Rare Diagnoses

  • Gouty Arthritis: Although the patient has a history of gout, the acute onset of symptoms after a fall makes this diagnosis less likely. However, it is still possible, especially if the trauma caused a gout flare.
  • Pseudogout (Calcium Pyrophosphate Deposition Disease): This condition can cause sudden, severe joint pain and swelling, but it is relatively rare and would be less likely in this scenario without other supporting evidence.
  • Elbow Osteomyelitis: This is a rare but serious infection of the bone that could cause pain, swelling, and warmth. It would be unusual in this scenario without other risk factors or symptoms.

Professional Medical Disclaimer

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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