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Last updated: September 7, 2025View editorial policy

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Differential Diagnosis for Flank Pain

Flank pain can be a symptom of various conditions, and a thorough differential diagnosis is essential to identify the underlying cause. Here's a categorized list of possible diagnoses:

  • Single most likely diagnosis
    • Nephrolithiasis (kidney stones): This is a common cause of flank pain, especially if the pain is severe and radiates to the groin. The pain is often accompanied by nausea, vomiting, and hematuria.
  • Other Likely diagnoses
    • Pyelonephritis (kidney infection): This condition can cause flank pain, fever, and urinary symptoms such as dysuria and frequency.
    • Musculoskeletal strain: Overuse or injury to the muscles in the flank area can cause pain and discomfort.
    • Urinary tract infection (UTI): A UTI can cause flank pain, especially if the infection has spread to the kidneys.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Renal artery embolism: This is a rare but life-threatening condition that requires prompt diagnosis and treatment.
    • Sickle cell crisis: Patients with sickle cell disease can experience flank pain due to vaso-occlusive crises, which can be life-threatening if not managed promptly.
    • Abdominal aortic aneurysm: A ruptured abdominal aortic aneurysm can cause flank pain, and it is essential to diagnose and treat this condition promptly to prevent mortality.
  • Rare diagnoses
    • Polycystic kidney disease (PKD): This genetic disorder can cause flank pain due to the growth of cysts on the kidneys.
    • Renal cell carcinoma: This type of kidney cancer can cause flank pain, hematuria, and other symptoms.
    • Retroperitoneal fibrosis: This rare condition involves the formation of fibrotic tissue in the retroperitoneum, which can cause flank pain and other symptoms.

It's essential to consider the patient's medical history, physical examination, and laboratory results to narrow down the differential diagnosis and arrive at the correct diagnosis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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