Differential Diagnosis for 24-year-old Male with Fatigue and Back Pain
- Single Most Likely Diagnosis
- Musculoskeletal strain: This is the most common cause of back pain in young adults, often due to overuse, poor posture, or minor trauma. The presence of fatigue could be related to the pain itself or to a lack of physical activity due to the pain.
- Other Likely Diagnoses
- Urinary tract infection (UTI) or pyelonephritis: Although more common in women, men can also develop UTIs, which can cause back pain (especially flank pain) and fatigue.
- Kidney stones: These can cause severe back pain (usually unilateral) and fatigue, especially if there is an associated infection.
- Herniated disk: This condition can cause back pain and fatigue, especially if the herniation is compressing a nerve root, leading to radiculopathy.
- Depression: Can manifest with somatic symptoms such as back pain and fatigue.
- Do Not Miss Diagnoses
- Spinal epidural abscess: A serious condition that requires immediate medical attention. Symptoms can include back pain, fever, and neurological deficits.
- Spinal cord compression: Can be due to various causes including trauma, infection, or tumor. It's a medical emergency that can lead to permanent neurological damage if not promptly treated.
- Testicular cancer with metastasis: Although rare, testicular cancer can metastasize to the spine or other areas, causing back pain and fatigue.
- Multiple myeloma: A type of blood cancer that can cause back pain due to bone lesions and fatigue due to anemia or other factors.
- Rare Diagnoses
- Ankylosing spondylitis: A form of arthritis that primarily affects the spine, although it can also affect other joints. It's characterized by chronic back pain and stiffness.
- Spondyloarthritis: A group of diseases that cause inflammation in the spine and other parts of the body, leading to back pain and stiffness.
- Osteomyelitis: An infection of the bone that can cause back pain and fatigue, especially if the spine is involved.
- Pott's disease (spinal tuberculosis): A rare condition in developed countries, but it can cause back pain, fatigue, and neurological symptoms due to spinal cord compression.