Differential Diagnosis for 49-year-old Female with Ear Pain
- Single most likely diagnosis
- Otitis externa: This condition, also known as swimmer's ear, is an inflammation of the outer ear and ear canal. The patient's report of ear pain worsened by movement of the ear and the absence of symptoms like nasal congestion or recent illness make this a likely diagnosis. The pain radiating to the lateral neck could be due to the involvement of the surrounding tissues.
- Other Likely diagnoses
- Temporomandibular joint (TMJ) disorder: Given the location of the pain and its radiation to the lateral neck, a TMJ disorder could be considered, especially if the patient has a history of jaw clenching, teeth grinding, or recent dental work.
- Cerumen impaction: The buildup of earwax can cause discomfort and pain, especially if it becomes impacted. This could be a possibility if the patient has not had regular ear cleanings or has used earbuds or Q-tips excessively.
- Ear canal dermatitis: An allergic reaction or irritation of the ear canal skin could cause pain and discomfort, especially if the patient has recently used new ear products or has allergies.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Malignant otitis externa: Although rare, this condition can occur in diabetic or immunocompromised patients and can lead to serious complications, including cranial nerve paralysis and death if not promptly treated.
- Mastoiditis: An infection of the mastoid bone, which is located behind the ear, can cause severe pain, fever, and other systemic symptoms. It is a serious condition that requires prompt medical attention.
- Temporal arteritis: This condition involves inflammation of the blood vessels in the temples and can cause severe headaches, jaw pain, and vision changes. Although less likely, it is a critical diagnosis to consider due to the risk of vision loss and other complications.
- Rare diagnoses
- Ramsay Hunt syndrome: A rare condition caused by the varicella-zoster virus, which can lead to facial paralysis, ear pain, and vesicles in the ear.
- Eosinophilic otitis media: A rare condition characterized by an accumulation of eosinophils in the middle ear, often associated with asthma or other allergic conditions.
- Relapsing polychondritis: A rare autoimmune disorder that can cause inflammation and destruction of cartilage in the ears, nose, and other areas.