Differential Diagnosis for Intermittent Right-Sided Pain
Single Most Likely Diagnosis
- Musculoskeletal strain: This is often the most common cause of intermittent pain, especially if the pain is related to movement or activity. The pain can come and go depending on the level of strain or activity.
Other Likely Diagnoses
- Gallbladder disease: Gallstones or cholecystitis can cause intermittent pain on the right side, especially after eating fatty foods. The pain can radiate to the back or right shoulder.
- Urinary tract infection or kidney stone: Infections or stones in the urinary tract can cause severe, intermittent pain on one side, often radiating to the groin.
- Hernia: An inguinal hernia can cause intermittent pain on the right side, especially with coughing, lifting, or straining.
- Constipation or irritable bowel syndrome (IBS): These conditions can cause intermittent abdominal pain, including on the right side, often accompanied by changes in bowel habits.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically presents with constant pain, it can start as intermittent pain on the right side. Missing this diagnosis can lead to severe complications.
- Ectopic pregnancy: In women, an ectopic pregnancy can cause intermittent, severe pain on one side, and is a medical emergency.
- Pulmonary embolism: A pulmonary embolism can cause sudden, severe pain on one side of the chest, which can radiate to the back or arm.
- Aortic dissection: This is a rare but life-threatening condition where the aorta tears, causing severe, intermittent pain that can radiate to the back or abdomen.
Rare Diagnoses
- Intestinal obstruction: A blockage in the intestine can cause severe, intermittent pain, often accompanied by vomiting, constipation, or abdominal distension.
- Inflammatory bowel disease (Crohn's disease or ulcerative colitis): These conditions can cause chronic, intermittent pain, often accompanied by changes in bowel habits, weight loss, or fever.
- Right-sided diverticulitis: Diverticulitis on the right side of the colon can cause intermittent pain, often accompanied by changes in bowel habits or fever.
- Ovarian torsion or cyst: In women, ovarian torsion or a ruptured ovarian cyst can cause severe, intermittent pain on one side, often accompanied by nausea or vomiting.