Hand pain

DDx

• Trauma or overuse, eg, fracture, dislocation, tendinitis
• Trigger finger
• Arthritis, eg, osteoarthritis (DIP & PIP joints), rheumatoid arthritis (MCPs, not DIPs), psoriatic arthritis, reactive arthritis (Reiter’s syndrome), gout, septic arthritis
• Finger: felon (infected pad), paronychia, subungual hematoma
• Area of first CMC joint: osteoarthritis, DeQuervain’s tenosynovitis, scaphoid fracture (snuffbox pain)
• Carpal tunnel syndrome
• Pronator teres syndrome (median nerve entrapment at level of pronator teres)
• Flexor tenosynovitis, eg, overuse, rheumatoid arthritis, gonococcal
• Dupuytren’s contracture
• Ulnar nerve entrapment at the wrist
• Brachial plexus neuropathy
• Cervical nerve root compression, eg, herniated disk
• Superficial radial neuropathy (cheiralgia paresthetica or handcuff neuropathy)
• Reflex sympathetic dystrophy
• Thoracic outlet syndrome
• Vascular, eg, Raynaud’s syndrome, thromboangiitis obliterans (Buerger’s disease), erythromelalgia
• Angina pectoris (left-sided pain)