Differential Diagnosis for a Palpable Clicking Soft Tissue Mass in the Elbow After a Fall
Single Most Likely Diagnosis
- Olecranon Bursitis: This condition is characterized by inflammation of the bursa at the elbow, which can cause a palpable soft tissue mass. A fall onto the elbow can cause trauma to the bursa, leading to bursitis. The clicking sensation could be due to fluid accumulation or bursal thickening.
Other Likely Diagnoses
- Elbow Hematoma: A fall can cause bleeding into the soft tissues around the elbow, resulting in a palpable mass. The clicking sensation might be due to the movement of clots within the hematoma.
- Elbow Contusion or Soft Tissue Injury: Direct trauma to the elbow can cause soft tissue injury, including muscle or tendon damage, which might present as a palpable mass with a clicking sensation due to irregularities in the injured tissue.
- Ulnar Nerve Subluxation: Although less common, a fall could potentially cause subluxation of the ulnar nerve, which might present with a palpable, clicking mass if the nerve moves in and out of its normal position.
Do Not Miss Diagnoses
- Septic Arthritis or Osteomyelitis: Although less likely, these conditions are critical to diagnose early due to their potential for severe consequences, including joint destruction and systemic infection. A normal X-ray does not rule out these conditions, especially in the early stages.
- Vascular Injury: Trauma to the elbow can cause injury to the brachial artery or its branches, leading to complications such as compartment syndrome or ischemia. A palpable mass could be a hematoma related to vascular injury.
Rare Diagnoses
- Ganglion Cyst: These are benign cysts that can occur around joints, including the elbow. While they can cause a palpable mass, they are less likely to be directly related to a recent fall.
- Lipoma or Other Soft Tissue Tumors: Pre-existing soft tissue tumors could potentially become more noticeable after a fall, but they would be an uncommon cause of a new onset, palpable clicking mass following trauma.
- Elbow Dislocation or Subluxation with Interposed Soft Tissue: Although a normal X-ray makes this less likely, it's a rare possibility where soft tissue becomes interposed, preventing full reduction of the joint, and could cause a palpable, clicking mass.