Differential Diagnosis for 51 year old female with right lower flank pain radiating to hip and groin

• Single most likely diagnosis
  • Nephrolithiasis (Kidney Stones): The patient's symptoms of flank pain radiating to the groin are classic for nephrolithiasis, which is a common condition where a stone in the kidney or ureter causes severe pain.
• Other Likely diagnoses
  • Musculoskeletal strain: The pain radiating to the hip and groin could also be due to a musculoskeletal issue, such as a strain in the lower back or hip.
  • Pyelonephritis: An infection of the kidney, which could cause flank pain and potentially radiate to the groin.
  • Ovarian cyst or torsion: Although less common, ovarian pathology could cause pain that radiates to the groin.
• Do Not Miss diagnoses
  • Appendicitis: Although the pain is on the right side, which is consistent with appendicitis, the radiation to the groin is less typical. However, it's a diagnosis that cannot be missed due to its potential for severe complications if not treated promptly.
  • Ectopic pregnancy: Although less likely in a 51-year-old female, it's not impossible, especially if she is perimenopausal or has an irregular menstrual cycle. Ectopic pregnancy is a medical emergency.
  • Aortic dissection or abdominal aortic aneurysm: These are life-threatening conditions that could present with severe flank or back pain, and while less common, they must be considered.
• Rare diagnoses
  • Retroperitoneal fibrosis: A rare condition where fibrotic tissue forms in the retroperitoneum and can cause pain and obstructive uropathy.
  • Psoas abscess: An abscess in the psoas muscle, which could cause flank and groin pain, although this is relatively rare.
  • Spinal pathology (e.g., spinal stenosis, disc herniation): While more common causes of back pain, in rare cases, they could radiate pain to the groin area.