Differential Diagnosis
The provided CT scan report reveals a pinpoint non-obstructing right renal calculus with no other acute abnormalities in the abdomen or pelvis. Based on this information, the following differential diagnoses can be considered:
- Single most likely diagnosis
- Renal colic due to the non-obstructing right renal calculus: This is the most likely diagnosis given the presence of a renal calculus, which is a common cause of renal colic.
- Other Likely diagnoses
- Nephrolithiasis: The presence of a renal calculus suggests that the patient may have a history of nephrolithiasis, which is a condition characterized by the formation of kidney stones.
- Diverticulitis: Although the report mentions a calcified or inspissated contrast within a diverticulum, which is unchanged from a prior study, it is still possible that the patient may have diverticulitis, especially if they are experiencing abdominal pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Appendicitis: Although the report states that there is no CT evidence of acute appendicitis, it is essential to consider this diagnosis, as a missed appendicitis can lead to severe complications, including perforation and peritonitis.
- Aortic dissection or aneurysm: Although the report mentions that the aorta is of normal caliber, it is crucial to consider aortic dissection or aneurysm, as these conditions can be life-threatening if not promptly diagnosed and treated.
- Bowel obstruction or ischemia: Although the report states that there is no evidence of obstruction or bowel wall thickening, it is essential to consider these diagnoses, as they can be life-threatening if not promptly diagnosed and treated.
- Rare diagnoses
- Renal cell carcinoma: Although the report mentions that the kidneys are normal in size, shape, and position, with no focal masses, it is still possible that the patient may have a renal cell carcinoma, which is a rare but potentially life-threatening condition.
- Lymphoma: Although the report mentions that there are no abnormal masses or lymphadenopathy, it is still possible that the patient may have lymphoma, which is a rare but potentially life-threatening condition.