Differential Diagnosis for 32 y/o Female with Urinary Frequency, Left Flank Pain, and Normal Urinalysis
- Single Most Likely Diagnosis
- Ureteral Stone: The presentation of left flank pain and urinary frequency in a young adult, without fever or abnormal urinalysis, is highly suggestive of a ureteral stone. The pain is often severe and can radiate to the groin. The absence of infection signs (afebrile, normal urinalysis) supports this diagnosis, as stones can cause obstruction and pain without necessarily causing an infection.
- Other Likely Diagnoses
- Pyelonephritis without significant bacteriuria: Although the patient is afebrile and has a normal urinalysis, it's possible for pyelonephritis to present atypically, especially in early stages or in individuals with partial immunity or those who have been partially treated.
- Interstitial Cystitis: This condition can cause urinary frequency and pelvic pain, which might be referred to the flank area. It's more common in women and can be challenging to diagnose.
- Overactive Bladder: Could cause urinary frequency, but flank pain would be less typical for this condition.
- Do Not Miss Diagnoses
- Ectopic Pregnancy: Although less likely given the presentation, an ectopic pregnancy can cause flank pain and urinary frequency due to the proximity of the fallopian tubes to the ureters and bladder. This diagnosis is critical to consider in any female of childbearing age with abdominal or pelvic pain.
- Appendicitis: Can sometimes present with flank pain if the appendix is retrocecal. The absence of fever and normal urinalysis does not rule out appendicitis.
- Ovarian Torsion or Cyst: These conditions can cause severe pain that might be referred to the flank area and are emergencies that require prompt surgical intervention.
- Rare Diagnoses
- Genitourinary Tuberculosis: Can cause chronic flank pain and urinary frequency. It's rare in many parts of the world but should be considered, especially if there's a relevant travel or exposure history.
- Malacoplakia: A rare inflammatory condition that can affect the urinary tract and cause a variety of symptoms, including flank pain and urinary frequency.
- Ureteral Stricture or Obstruction due to other causes: Such as tumors or fibrosis, which are less common but could present with similar symptoms.