From the Guidelines
Right Lower Quadrant (RLQ) pain is most commonly caused by appendicitis.
Common Causes of RLQ Pain
- Appendicitis is the most common surgical pathology responsible for RLQ abdominal pain in the United States 1
- Other less frequent causes of RLQ pain include:
- Right colonic diverticulitis
- Ureteral stone
- Colitis
- Intestinal obstruction 1
Diagnosis of RLQ Pain
Imaging remains the diagnostic mainstay in the workup of patients presenting with RLQ abdominal pain for evaluation of suspected appendicitis and diagnosis of other conditions 1.
- Contrast-enhanced CT is the primary and most appropriate imaging modality to evaluate this patient population 1
- MRI is approaching CT in sensitivity and specificity as this technology becomes more widely available and utilization increases 1
- Unenhanced MRI and ultrasound remain the diagnostic procedures of choice in the pregnant patient 1 In patients with suspected appendicitis, the choice of imaging modality should be tailored for diagnosis of acute appendicitis, but should also allow diagnosis of other causes of RLQ pain to triage appropriate patient management 1.
From the Research
Causes of Right Lower Quadrant (RLQ) Pain
The causes of RLQ pain are diverse and can be attributed to various conditions, including:
- Acute appendicitis (AA) 2, 3, 4, 5, 6
- Inflammatory and infectious conditions involving the ileocecal region 3
- Diverticulitis 3
- Malignancies 3
- Conditions affecting the epiploic appendages, omentum, and mesentery 3
- Urinary diseases 4
- Gynecologic diseases and conditions associated with pregnancy in females 4
- Other appendiceal diseases 4
- Inflammatory bowel diseases 4
- Nonbowel gastrointestinal conditions 4
Diagnostic Approaches
Imaging modalities such as CT, US, and MRI play a crucial role in detecting the causes of RLQ pain 2, 3, 4, 5, 6.
- CT remains the primary modality for evaluation, while US and MRI are useful in specific cases, such as pediatric and pregnant patients 2
- Multidetector CT has emerged as a valuable tool for diagnosis and management of RLQ pain 3
- Ultrasonography is also useful in diagnosing RLQ pain, particularly in cases of acute appendicitis 4
- Nonfocused appendiceal CT can help identify various causes of RLQ pain, including appendicitis and other diseases 5