Differential Diagnosis for Right Middle Finger Hardness at MCP Joint
- Single most likely diagnosis
- Dupuytren's contracture: This condition is characterized by the thickening of the palmar fascia, leading to nodules and cord formation, which can cause the finger to feel hard, especially at the MCP joint. The mild pain when closing the fist and the absence of swelling support this diagnosis.
- Other Likely diagnoses
- Ganglion cyst: Although typically associated with swelling, a small ganglion cyst at the MCP joint could cause hardness and mild pain, especially if it is not yet large enough to cause noticeable swelling.
- Osteoarthritis: Early stages of osteoarthritis at the MCP joint could lead to bony hardness and mild pain, particularly with activities like closing the fist.
- Trigger finger: This condition, also known as stenosing tenosynovitis, can cause the finger to feel stiff or hard, especially if the tendon sheath is inflamed or if there is a nodule on the tendon that catches as the finger flexes.
- Do Not Miss diagnoses
- Infection (e.g., osteomyelitis or septic arthritis): Although less likely given the absence of swelling and significant pain, an infection could lead to hardness and pain, especially if it involves the bone or joint. Missing this diagnosis could lead to serious complications.
- Tumor (e.g., giant cell tumor of the tendon sheath): A tumor could cause localized hardness and pain, and while rare, it is crucial not to miss such a diagnosis due to its potential impact on the patient's health.
- Rare diagnoses
- Scleroderma: This autoimmune disease can cause skin and tissue hardening, which might be felt in the fingers, including at the MCP joints.
- Diabetic cheiroarthropathy: This condition, associated with long-standing diabetes, can lead to limited joint mobility and hardness in the hands, including the fingers at the MCP joints.