Differential Diagnosis for 72-year-old with 3-week pain from left loin to groin
- Single most likely diagnosis
- Nephrolithiasis (kidney stones) - The pain radiating from the left loin to the groin is a classic presentation for a ureteral stone, which is causing obstruction and pain.
- Other Likely diagnoses
- Musculoskeletal strain - Given the age of the patient and the location of the pain, a musculoskeletal issue such as a strain or sprain in the lumbar region could be a possible cause.
- Lumbar disc herniation - A herniated disc in the lumbar spine could cause pain radiating down to the groin area.
- Diverticulitis - Inflammation of a diverticulum in the colon could cause left lower quadrant pain that might radiate to the groin.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Abdominal aortic aneurysm (AAA) - Although less likely, an AAA could present with back or flank pain and is a medical emergency.
- Renal infarction - A blockage of the renal artery could cause severe flank pain and is a serious condition that requires prompt attention.
- Testicular torsion (less likely in this age group but possible) - This is a surgical emergency that requires immediate attention.
- Rare diagnoses
- Psoas abscess - An abscess in the psoas muscle could cause pain in the lower back and groin area, although this is a less common condition.
- Retroperitoneal fibrosis - A rare condition characterized by the proliferation of fibrous tissue in the retroperitoneum, which could cause back and abdominal pain.
- Spinal tumors - Tumors in the spine, such as metastases or primary spinal tumors, could cause back pain radiating to the groin.