Differential Diagnosis for 31y Female with Hip Pain
Single Most Likely Diagnosis
- Pregnancy-related hip pain: The presence of a retroflexed uterus and pelvic ascites on MRI suggests that the patient may be pregnant, and the hip pain could be related to the pregnancy. The red marrow conversion of the osseous structures can also be seen in pregnancy due to increased demand for blood cell production.
Other Likely Diagnoses
- Endometriosis: The retroflexed uterus and pelvic ascites could be indicative of endometriosis, which is a common cause of hip pain in women of reproductive age. The red marrow conversion could be an incidental finding.
- Ovarian cyst or mass: A small pelvic ascites and retroflexed uterus could be related to an ovarian cyst or mass, which could cause hip pain due to pressure or irritation of surrounding structures.
Do Not Miss Diagnoses
- Ectopic pregnancy: Although the MRI does not show any evidence of a fracture or joint effusion, an ectopic pregnancy could cause hip pain and pelvic ascites. This diagnosis is critical to rule out due to its potential for severe consequences if missed.
- Ovarian torsion: A retroflexed uterus and pelvic ascites could be indicative of ovarian torsion, which is a surgical emergency. The lack of specific findings on MRI does not rule out this diagnosis.
Rare Diagnoses
- Gaucher's disease: Red marrow conversion of the osseous structures can be seen in Gaucher's disease, a rare genetic disorder. However, this diagnosis would be unlikely without other supporting clinical or laboratory findings.
- Lymphoma or other malignancy: Red marrow conversion can also be seen in lymphoma or other malignancies, but this would be an uncommon presentation without other systemic symptoms or findings.