Differential Diagnosis for Lower Back Pain with Radiation to Groin
- Single most likely diagnosis
- Lumbar Herniated Disc: This is the most common cause of lower back pain radiating to the groin due to the compression of nerve roots, particularly L2-L4, which can refer pain to the groin area.
- Other Likely diagnoses
- Lumbar Spondylosis: Degenerative changes in the lumbar spine can cause pain radiating to the groin due to foraminal stenosis or facet joint osteoarthritis.
- Piriformis Syndrome: Although more commonly associated with sciatic pain, in some cases, the piriformis muscle can compress nerves that refer pain to the groin.
- Osteitis Condensans Ilii: A condition characterized by increased bone density in the ilium, often associated with lower back pain and sometimes radiating pain to the groin.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Abdominal Aortic Aneurysm (AAA): A potentially life-threatening condition that can cause lower back pain radiating to the groin, especially if the aneurysm is expanding or leaking.
- Kidney Stones: Severe pain from kidney stones can radiate from the flank to the groin and must be promptly diagnosed and treated.
- Spinal Infection (e.g., Discitis, Osteomyelitis): Infections of the spine can cause severe back pain and may radiate to the groin, requiring urgent medical attention.
- Spinal Tumors: Both primary and metastatic tumors can cause back pain radiating to unusual areas, including the groin, and are critical to diagnose early.
- Rare diagnoses
- Referred Pain from Intra-abdominal Pathology: Certain conditions like pancreatitis or inflammatory bowel disease can refer pain to the lower back and groin.
- Nerve Entrapment Syndromes (e.g., Ilioinguinal or Iliohypogastric Nerve Entrapment): These can cause pain in the groin area and sometimes lower back pain, depending on the nerve involved.
- Facet Joint Cysts: Rarely, cysts can form on the facet joints of the spine and compress nerves, leading to radiating pain.