Differential Diagnosis for Lower Abdominal Pain
Single Most Likely Diagnosis
- Musculoskeletal strain: The patient's symptoms started after stretching, which suggests a mechanical cause for the pain. The sharp pain that increased in severity is consistent with a muscle strain, which is a common and relatively benign condition.
Other Likely Diagnoses
- Urinary tract infection (UTI): Although the patient does not mention any urinary symptoms, UTIs can cause lower abdominal pain, especially in young men. The pain can be sharp and increase in severity over time.
- Inguinal hernia: The patient's age and sex, as well as the location of the pain, make inguinal hernia a possible diagnosis. Hernias can cause sharp pain, especially if they become incarcerated or strangulated.
- Constipation or bowel obstruction: Although the patient does not mention any changes in bowel habits, constipation or bowel obstruction can cause lower abdominal pain, especially if the obstruction is partial.
Do Not Miss Diagnoses
- Appendicitis: Although the patient's symptoms do not classicly suggest appendicitis (e.g., no migration of pain to the right lower quadrant), it is a diagnosis that must be considered, especially if the pain is severe and persistent. Appendicitis can be life-threatening if not treated promptly.
- Testicular torsion: This is a medical emergency that requires prompt attention. Although the patient does not mention any testicular symptoms, torsion can cause lower abdominal pain, especially if the pain radiates to the testicles.
- Ectopic pregnancy (if the patient's partner is pregnant): Although the patient is male, if his partner is pregnant, ectopic pregnancy must be considered, especially if the patient's pain is severe and persistent.
Rare Diagnoses
- Ovarian torsion (if the patient has a female partner with ovarian pathology): Similar to testicular torsion, ovarian torsion is a rare but life-threatening condition that requires prompt attention.
- Intussusception: This is a rare condition in adults, but it can cause lower abdominal pain, especially if the intussusception is partial.
- Diverticulitis: Although diverticulitis typically occurs in older adults, it can cause lower abdominal pain, especially if the diverticula are located in the sigmoid colon.