Differential Diagnosis for Left Groin Pain with Lumbar Radiculopathy

Single Most Likely Diagnosis

• Lumbar Herniated Disc: This is the most likely diagnosis because lumbar herniated discs can cause both groin pain (if the disc herniates and compresses nerves that travel down to the groin area) and lumbar radiculopathy (pain that radiates along the path of a nerve). The symptoms can vary depending on the location and size of the herniation.

Other Likely Diagnoses

• Lumbar Spondylosis: This condition involves wear and tear on the discs and joints in the lumbar spine, which can lead to radiculopathy and referred pain to the groin area.
• Piriformis Syndrome: Although more commonly associated with sciatic pain, in some cases, the piriformis muscle can compress nerves that refer pain to the groin area, especially if the nerve roots involved are higher up (e.g., L2, L3).
• Lumbar Facet Joint Syndrome: Inflammation or degeneration of the facet joints in the lumbar spine can cause pain that may radiate to the groin, especially if the joints are irritated or inflamed.

Do Not Miss Diagnoses

• Abdominal Aortic Aneurysm (AAA): Although less common, an AAA can cause lower back pain that radiates to the groin. This is a medical emergency, and missing the diagnosis can be fatal.
• Kidney Stones: Severe pain from kidney stones can radiate from the flank to the groin and may mimic radiculopathy. It's crucial to differentiate this condition due to its urgency and the need for specific treatment.
• Ovarian Cysts or Torsion (in females): These conditions can cause severe, acute pain that may be referred to the groin area and can sometimes be accompanied by lower back pain, mimicking radiculopathy.

Rare Diagnoses

• Neurogenic Tumors: Rarely, tumors originating from the nerves (like neurofibromas or schwannomas) can cause radiculopathy and pain that might be referred to the groin area.
• Inflammatory or Infectious Processes: Conditions such as spinal epidural abscess, osteomyelitis, or discitis can cause severe back pain and radiculopathy, including pain referred to the groin, though these are less common and usually present with additional symptoms like fever or significant neurological deficits.
• Referred Pain from Visceral Sources: Certain conditions affecting abdominal organs (e.g., pancreatitis, diverticulitis) can cause referred pain to the back and groin area, though the primary symptoms usually relate to the abdominal issue.