Approach to Hand Pain

Differential diagnosis

• Raynaud’s phenomenon
  • Primary Raynaud’s
  • Systemic sclerosis
    • Limited
    • Diffuse
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
• Inflammatory arthritis
  • Symmetrical deforming
    • Rheumatoid arthritis
    • Jaccoud’s arthropathy
    • Psoriatic arthropathy (RA type)
  • Seronegative
    • Psoriatic arthropathy
    • Inflammatory bowel disease
    • Reactive arthritis
    • Gonococcal arthritis
    • Ankylosing spondylitis
  • Osteoarthritis
• Carpal tunnel syndrome
  • Endocrine
    • Diabetes
    • Hypothyroidism
    • Acromegaly
  • Metabolic
    • Uraemia
    • Obesity
  • Inflammatory
    • Rheumatoid arthritis
    • Jaccoud’s arthropathy
    • Psoriatic arthritis
  • Pregnancy
  • Structural
    • Trauma
    • Repetitive strain injury