Differential Diagnosis for Sharp Pain in the Side with Dysuria

• Single most likely diagnosis
  • Kidney stone: The patient has a history of kidney stones, and the presentation of sharp pain in the side along with dysuria is consistent with a kidney stone, especially given the recurrent nature of the condition.
• Other Likely diagnoses
  • Urinary Tract Infection (UTI): Dysuria is a common symptom of UTIs, and while the sharp pain might not be as typical, it could be present, especially if the infection involves the upper urinary tract.
  • Pyelonephritis: An infection of the kidney, which could cause sharp pain and dysuria, although it often presents with additional symptoms like fever and flank pain.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Appendicitis: Although the pain is on the side, appendicitis can sometimes present with pain that radiates or is felt in the flank, and it's a condition that requires prompt surgical intervention.
  • Ectopic Pregnancy: In women of childbearing age, ectopic pregnancy is a critical diagnosis to consider with abdominal or pelvic pain, as it can be life-threatening if not recognized and treated promptly.
  • Sepsis (from any cause, including urinary or abdominal source): Sepsis is a life-threatening condition that can arise from various infections, including those of the urinary tract or abdominal organs.
• Rare diagnoses
  • Renal Infarction: A rare condition where the blood supply to the kidney is interrupted, leading to tissue death. It can present with acute flank pain and might be considered in the differential, especially if there are risk factors for thromboembolism.
  • Retroperitoneal Hemorrhage: Bleeding into the space behind the peritoneum, which can be caused by trauma, anticoagulation, or vascular abnormalities, and might present with flank pain.