Differential Diagnosis for Right Hip Pain, Lumbosacral Spine Pain, and Pain upon Lifting Arm
Single Most Likely Diagnosis
- Lumbar Radiculopathy: This condition, often due to a herniated disc, can cause pain in the lumbosacral spine that radiates to the hip and can be exacerbated by movements such as lifting, which can increase pressure on the affected nerve root.
Other Likely Diagnoses
- Trochanteric Bursitis: Inflammation of the bursa over the greater trochanter of the femur can cause hip pain, especially when lying on the side or climbing stairs, and might be exacerbated by lifting due to increased tension on the surrounding muscles.
- Piriformis Syndrome: The piriformis muscle can compress the sciatic nerve, leading to pain in the hip and buttock that may radiate down the leg. Lifting or certain movements can irritate the muscle and worsen symptoms.
- Lumbosacral Strain: Muscle strain in the lower back can cause pain in the lumbosacral area and hip, particularly with lifting or bending, due to overuse or injury of the muscles.
Do Not Miss Diagnoses
- Cauda Equina Syndrome: A serious condition where the nerves in the spinal canal are compressed, leading to severe pain, numbness, and potentially bladder and bowel dysfunction. It requires immediate medical attention.
- Spinal Infection (e.g., Osteomyelitis, Discitis): Infections of the spine can cause severe back pain, fever, and potentially neurological deficits. Early diagnosis and treatment are crucial to prevent long-term damage.
- Spinal Tumor: Tumors in the spine can cause progressive back pain, neurological symptoms, and systemic symptoms like weight loss. Prompt diagnosis is essential for effective treatment.
Rare Diagnoses
- Osteonecrosis of the Femoral Head: A condition where the blood supply to the femoral head is interrupted, leading to bone death and potentially severe hip pain. It can be related to trauma, steroids, or other factors.
- Sacroiliitis: Inflammation of the sacroiliac joints, which can cause pain in the lower back, hip, and sometimes radiate down the leg. It can be due to inflammatory arthritis, infection, or other causes.
- Referred Pain from Abdominal or Pelvic Pathology: Certain conditions like appendicitis, kidney stones, or ovarian cysts can refer pain to the hip or lower back area, and while less common, should be considered in the differential diagnosis, especially if other symptoms are present.