Differential Diagnosis for Pain in Right Lower Abdominal Region
Single Most Likely Diagnosis
- Musculoskeletal strain: The pain being exacerbated by movement and the absence of tenderness on palpation suggest a musculoskeletal origin, such as a strain in the abdominal wall muscles.
Other Likely Diagnoses
- Ovarian cyst (in females): Although there's no tenderness on palpation, ovarian cysts can cause intermittent pain that worsens with movement.
- Inguinal hernia: Hernias can cause pain in the lower abdominal region, especially with movement or coughing, and may not always be palpable.
- Constipation or bowel obstruction (less likely given normal bowel habit, but possible if the obstruction is partial): Early stages of bowel obstruction might not present with significant tenderness or altered bowel habits.
Do Not Miss Diagnoses
- Appendicitis: Although the classic presentation includes tenderness on palpation, early or atypical appendicitis might not have these findings. It's crucial to consider appendicitis due to its potential for serious complications if missed.
- Ectopic pregnancy (in females): This is a life-threatening condition that can present with lower abdominal pain and might not always have significant tenderness on palpation initially.
- Intestinal ischemia: This condition can cause severe abdominal pain out of proportion to the physical examination findings and is critical to diagnose early to prevent significant morbidity and mortality.
Rare Diagnoses
- Right lower lobe pneumonia: Referred pain from a lower lobe pneumonia can sometimes present as abdominal pain, especially if the diaphragm is involved.
- Ureteral stone: Although more commonly associated with flank pain, a stone in the distal ureter can cause pain in the lower abdomen.
- Endometriosis (in females): This chronic condition can cause cyclic pain that might worsen with movement, though it's less likely to be the primary diagnosis in an acute setting without other symptoms.