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Last updated: June 11, 2025View editorial policy

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Differential Diagnosis for Flank Pain without Kidney Stone

  • Single most likely diagnosis
    • Musculoskeletal strain: This is often the most common cause of flank pain in the absence of kidney stones. The muscles in the back and flank area can become strained due to heavy lifting, bending, or sudden movements, leading to pain.
  • Other Likely diagnoses
    • Pyelonephritis (kidney infection): An infection of the kidney can cause flank pain, fever, and other symptoms. It's a common cause of flank pain and should be considered, especially if there are signs of infection.
    • Lower back strain or herniated disc: Problems with the spine, such as a herniated disc or strain, can radiate pain to the flank area.
    • Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause pain that may be felt in the flank area.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Pulmonary embolism: Although less common, a pulmonary embolism can cause sudden, severe flank pain, especially if the embolism is large and affects the upper parts of the lung.
    • Aortic dissection: A tear in the aorta can cause severe, tearing pain that may be felt in the flank area, and is a medical emergency.
    • Pneumonia: Certain types of pneumonia, especially those affecting the upper parts of the lung, can cause flank pain.
  • Rare diagnoses
    • Pancreatitis: Inflammation of the pancreas can cause severe abdominal and flank pain, although it's less common.
    • Retroperitoneal fibrosis: A rare condition where fibrotic tissue forms in the retroperitoneum, which can cause flank pain and other symptoms.
    • Spinal tumors or infections: Tumors or infections affecting the spine can cause flank pain, although these are relatively rare causes.

Professional Medical Disclaimer

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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