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Differential Diagnosis for Right Lower Back and Leg Pain

  • Single most likely diagnosis
    • Lumbar Radiculopathy (L4 or L5 nerve root impingement): The patient's symptoms of radiating pain down the right hip, lateral and anterior thigh, burning into the knee, and ankle, along with groin pain, are consistent with lumbar radiculopathy. The pain worsening with knee bending and lack of positional relief also support this diagnosis.
  • Other Likely diagnoses
    • Lumbar Disc Herniation: The patient's symptoms of radiating pain and worsening with movement are consistent with a lumbar disc herniation, which can cause nerve root impingement.
    • Piriformis Syndrome: The patient's symptoms of pain radiating down the thigh and into the knee, along with worsening pain with movement, could be consistent with piriformis syndrome, which involves compression of the sciatic nerve by the piriformis muscle.
    • Trochanteric Bursitis: The patient's symptoms of pain in the hip and thigh could be consistent with trochanteric bursitis, which involves inflammation of the bursa over the trochanter.
  • Do Not Miss diagnoses
    • Cauda Equina Syndrome: Although less likely, cauda equina syndrome is a serious condition that requires prompt diagnosis and treatment. The patient's symptoms of radiating pain, groin pain, and worsening with movement could be consistent with cauda equina syndrome, which involves compression of the cauda equina nerves in the lumbar spine.
    • Abdominal Aortic Aneurysm: The patient's symptoms of groin pain and radiating pain could be consistent with an abdominal aortic aneurysm, which is a life-threatening condition that requires prompt diagnosis and treatment.
  • Rare diagnoses
    • Neuropathic Arthropathy (Charcot Joint): The patient's symptoms of radiating pain and worsening with movement could be consistent with neuropathic arthropathy, which involves degeneration of a joint due to nerve damage.
    • Spinal Tumor or Infection: Although rare, spinal tumors or infections could cause the patient's symptoms of radiating pain and worsening with movement, and should be considered in the differential diagnosis.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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