Differential Diagnosis for 67-year-old Male with Right Groin Pain
- Single most likely diagnosis
- Inguinal Hernia: The patient's symptoms of sudden onset of severe groin pain, especially after lifting a heavy object, are highly suggestive of an inguinal hernia. The inability to stand upright due to pain further supports this diagnosis.
- Other Likely diagnoses
- Strain or Pull of the Adductor Muscles: Lifting a heavy object like a mini fridge could lead to a strain or pull of the adductor muscles, which are located in the groin area.
- Osteitis Pubis: This is an inflammatory condition that affects the pubic bone and surrounding structures, often caused by repetitive stress or trauma, which could be a consideration given the patient's recent activity.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Testicular Torsion: Although less common in older adults, testicular torsion is a medical emergency that requires prompt attention. The severe pain and nausea could be indicative of this condition.
- Aortic Aneurysm or Aortic Dissection: While the presentation might not be typical, aortic aneurysm or dissection could potentially cause groin pain if the aneurysm is large enough to compress surrounding structures or if there is retroperitoneal bleeding.
- Hip Fracture: Although the patient denies any fall, it's essential to consider hip fracture, especially in an elderly patient with severe pain that prevents standing upright.
- Rare diagnoses
- Avulsion Fracture of the Lesser Trochanter: This is a rare condition where a fragment of bone is pulled off by a tendon or ligament, which could occur due to the force exerted while lifting the mini fridge.
- Sportsman's Hernia (Gilmore's Groin): A condition characterized by a chronic groin pain due to a weakness in the abdominal wall, often seen in athletes but could potentially occur in anyone engaging in strenuous activity.