Differential Diagnosis for Right Flank Pain
Single Most Likely Diagnosis
- Nephrolithiasis (Kidney Stones): This is often the most common cause of acute flank pain, especially if the pain is severe and radiates to the groin. The right flank is a typical location for pain associated with kidney stones due to the anatomy of the urinary tract.
Other Likely Diagnoses
- Pyelonephritis: An infection of the kidney, which can cause flank pain, fever, and other urinary symptoms. The right flank can be affected, and the condition is more common in women.
- Musculoskeletal Strain: Overuse or injury to the muscles in the flank area can cause pain, which might be exacerbated by movement or palpation.
- Hepatic or Biliary Disease: Conditions like hepatitis, cholecystitis, or a liver abscess can cause right upper quadrant or flank pain due to the proximity of these organs to the right flank.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically presents with right lower quadrant pain, it can occasionally cause flank pain if the appendix is retrocecal (located behind the cecum). Missing this diagnosis can lead to perforation and severe complications.
- Pulmonary Embolism: In rare cases, a pulmonary embolism can cause referred pain to the flank area, especially if the embolism is large and affects the upper lobes of the lungs. This is a life-threatening condition that requires immediate attention.
- Aortic Dissection or Aneurysm: These are serious vascular conditions that can cause severe, tearing flank pain. They are less common but critical to diagnose promptly to prevent fatal outcomes.
Rare Diagnoses
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic hypertension and flank pain.
- Renal Cell Carcinoma: A type of kidney cancer that might cause flank pain, although it is more commonly asymptomatic until late stages.
- Spinal Pathologies: Conditions like spinal infections, tumors, or disc herniations can cause flank pain, especially if they involve the nerves that supply the flank area.