Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: July 10, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for 68 yo Female with Lower Back Pain and Burning with Urination

Single Most Likely Diagnosis

  • Urinary Tract Infection (UTI) without pyuria: Although the absence of leukocytes or nitrates in the urine might seem to contradict this diagnosis, some UTIs, especially those caused by certain bacteria or in early stages, might not present with typical urinary findings. The symptoms of lower back pain and burning with urination are classic for UTI.

Other Likely Diagnoses

  • Kidney Stones: Can cause severe lower back pain (often radiating to the groin) and dysuria (painful urination), which aligns with the patient's symptoms. The absence of leukocytes or nitrates does not rule out this diagnosis.
  • Degenerative Disc Disease or Lumbar Spinal Stenosis: These conditions can cause lower back pain and, in some cases, may radiate pain or cause discomfort that could be interpreted as burning, especially if there's associated nerve root irritation.
  • Overactive Bladder: Could potentially cause discomfort or a sensation of burning during urination, though it's less directly linked to lower back pain.

Do Not Miss Diagnoses

  • Pyelonephritis: An infection of the kidney, which can present with lower back pain and symptoms of a UTI. Even without leukocytes or nitrates, this diagnosis should be considered due to its potential severity.
  • Spinal Epidural Abscess: A rare but serious condition that can cause back pain and neurological symptoms. Early diagnosis is crucial for effective treatment.
  • Cauda Equina Syndrome: A condition where the nerves in the spinal canal are compressed, leading to pain, numbness, and potentially bladder and bowel dysfunction. It's a medical emergency.

Rare Diagnoses

  • Interstial Cystitis: A condition causing bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can be similar to those of a UTI but without evidence of infection.
  • Schistosomiasis (in endemic areas): A parasitic infection that can cause urinary symptoms, including dysuria and hematuria, though it's less common in non-endemic areas.
  • Tuberculosis of the Urinary Tract: Can cause chronic lower back pain and urinary symptoms, including burning during urination, though it's relatively rare in many parts of the world.

Related Questions

For how long should mechanical ventilation be continued in patients with lung contusion (pulmonary contusion)?
What are the approved Transthyretin (TTR) stabilizer therapies besides tafamidis (Vyndaqel)?
What is the recommended treatment for a patient with a radial sclerosing lesion and ductal epithelial hyperplasia diagnosed on a left breast biopsy?
Do asymptomatic urinary tract infections (UTIs) in pregnancy require treatment?

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question