Differential Diagnosis for Unilateral Pain over the Left Iliac Crest
Single Most Likely Diagnosis
- Musculoskeletal strain or injury: This is often the most common cause of unilateral pain over the iliac crest due to its location and the frequency of strain or injury to the muscles and ligaments in this area.
Other Likely Diagnoses
- Trochanteric bursitis: Inflammation of the bursa over the trochanter, which is near the iliac crest, can cause pain in this area, especially if the patient has a history of repetitive hip movement or direct trauma.
- Iliac crest bone bruise or fracture: A direct blow to the iliac crest can cause a bone bruise or fracture, leading to localized pain.
- Lower back strain or radiculopathy: Pain from the lower back can radiate to the iliac crest area, especially if there is nerve involvement.
Do Not Miss Diagnoses
- Osteomyelitis or bone infection: Although less common, an infection of the bone in the iliac crest area can cause severe, localized pain and would require prompt antibiotic treatment.
- Ewing's sarcoma or other bone tumors: While rare, bone tumors can cause pain over the iliac crest and are critical to diagnose early for effective treatment.
- Abdominal or pelvic pathology referred to the iliac crest: Conditions such as a ruptured abdominal aortic aneurysm, kidney stones, or diverticulitis can sometimes refer pain to the iliac crest area due to shared nerve roots.
Rare Diagnoses
- Avulsion fracture of the iliac crest: This is a rare injury where a fragment of the iliac crest is pulled off by a muscle or ligament, typically seen in young athletes.
- Iliac crest apophysitis: An overuse injury affecting the growth plate of the iliac crest, more common in adolescents involved in sports.
- Paget's disease of bone: A chronic condition that can result in enlarged and misshapen bones due to abnormal bone destruction and regrowth, which can cause pain if it affects the iliac crest.