[49M] With arm pain and swelling post physical exertion

Patient Description

A 49-year-old male presents with pain and stiffness in the forearm near the elbow, which began suddenly the previous afternoon. The patient describes the pain as sharp, rating it 6-7 out of 10, and notes that it worsens with arm straightening. There is a warm, painful lump at the site of the pain, and the patient has observed bruising along the forearm extending to the hand, with what appears to be blood pooling around the knuckles. The patient has a history of rheumatoid arthritis diagnosed a year ago but is not on any medication due to a seizure suspected to be related to the arthritis medication. The patient also has carpal tunnel syndrome, which is scheduled for surgery, and experiences numbness and tingling in the hand and fingers, which he attributes to this condition. There is no reported weakness in the hand or arm, and no other medications are currently being taken.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Hematoma: A collection of blood outside of a blood vessel that can occur as a result of trauma or injury to the blood vessels. Hematomas can cause pain, swelling, and a lump, which aligns with your symptoms. The bruising and blood pooling you're seeing could be due to blood leaking from the injured blood vessel.
- Treatment typically involves rest, ice, compression, and elevation (RICE). However, in severe cases, a doctor may need to drain the hematoma.
Bursitis: Inflammation of the bursa, a small, fluid-filled sac that acts as a cushion between a bone and other moving parts, such as muscles, tendons, or skin. Bursitis can cause pain, swelling, and difficulty moving the affected joint.
- Treatment typically involves rest, ice, and over-the-counter pain relievers. In severe cases, a doctor may need to drain the bursa or inject it with a corticosteroid to reduce inflammation.
Tendonitis: Inflammation or irritation of a tendon, the thick fibrous cords that attach muscle to bone. Tendonitis can cause pain and tenderness just outside a joint.
- Treatment typically involves rest, ice, and over-the-counter pain relievers. Physical therapy may also be beneficial.

Please note that these are just possibilities and not a definitive diagnosis.

What you can do

Rest and elevate the affected area. Avoid any activities that cause pain or may have caused the injury.
Apply ice to the area for 15 minutes at a time, several times a day.
Over-the-counter pain relievers, such as ibuprofen, can help reduce pain and inflammation.
If your symptoms persist or worsen, seek medical attention.

What you should look out for

If the pain, swelling, or bruising worsens
If you develop a fever or the area becomes red, hot, or more swollen, as these could be signs of an infection
If you experience severe pain, numbness, or tingling, or if you are unable to move the affected arm or hand

Remember, I'm an AI and this advice is based on the information you've provided. It's always a good idea to consult with a healthcare professional who can evaluate your condition and provide a formal diagnosis.

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11 mo ago

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