Differential Diagnosis for Unilateral Nasal Septal Pain

• Single most likely diagnosis
  • Nasal septal deviation or spurs: This is a common cause of unilateral nasal septal pain due to the abnormal shape of the nasal septum, which can lead to turbulence of airflow and irritation of the nasal mucosa.
• Other Likely diagnoses
  • Nasal septal perforation: A hole in the nasal septum can cause pain, crusting, and bleeding, and may be due to trauma, infection, or drug use.
  • Sinusitis: Inflammation of the paranasal sinuses can cause pain and pressure in the face, including the nasal septum.
  • Allergic rhinitis: Inflammation of the nasal mucosa due to allergies can cause pain, congestion, and itching in the nose.
  • Dryness or irritation of the nasal mucosa: Environmental factors such as dry air or exposure to irritants can cause pain and discomfort in the nasal septum.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Nasopharyngeal carcinoma: A rare but potentially life-threatening cancer that can cause nasal septal pain, bleeding, and obstruction.
  • Invasive fungal sinusitis: A rare but aggressive infection that can cause destruction of the nasal septum and surrounding tissues.
  • Granulomatosis with polyangiitis (GPA): A rare autoimmune disorder that can cause inflammation and destruction of the nasal septum and sinuses.
• Rare diagnoses
  • Sarcoidosis: A rare autoimmune disorder that can cause inflammation and granulomas in the nasal septum and sinuses.
  • Relapsing polychondritis: A rare autoimmune disorder that can cause inflammation and destruction of the cartilaginous structures in the nose, including the nasal septum.
  • Nasal septal abscess: A rare but potentially serious infection that can cause pain, swelling, and destruction of the nasal septum.