Differential Diagnosis for Right Flank Pain per Costophrenic Angle
Single Most Likely Diagnosis
- Pyelonephritis or Kidney Infection: This condition often presents with flank pain, which can radiate to the costophrenic angle, along with symptoms like fever, dysuria, and frequent urination. The pain is typically a result of the infection involving the renal parenchyma.
Other Likely Diagnoses
- Nephrolithiasis (Kidney Stones): Stones in the kidney can cause severe flank pain (renal colic) that may be felt in the costophrenic angle, especially if the stone is obstructing the ureteropelvic junction or is moving down the ureter.
- Musculoskeletal Strain: The muscles in the flank area can become strained due to heavy lifting, bending, or sudden movements, leading to pain that can be localized to the costophrenic angle.
- Pneumonia or Pleurisy: Inflammation of the lung (pneumonia) or the lining surrounding the lung (pleurisy) can cause pain that is felt in the chest and can radiate to the flank area, including the costophrenic angle, especially if the lower lobes are involved.
Do Not Miss Diagnoses
- Pulmonary Embolism: Although less common, a pulmonary embolism can present with sudden onset of chest pain that may radiate to the flank area, including the costophrenic angle, and is accompanied by symptoms like shortness of breath and tachycardia. This is a life-threatening condition that requires immediate medical attention.
- Ruptured Abdominal Aortic Aneurysm: This is a medical emergency where the aorta ruptures, leading to severe abdominal and back pain that can radiate to the flank area. It's less common but critical to diagnose promptly.
Rare Diagnoses
- Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, including the kidneys, which can lead to flank pain among other symptoms.
- Renal Cell Carcinoma: A type of kidney cancer that can cause flank pain, although it is typically a more chronic and less acute presentation compared to other conditions listed.
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic hypertension, sweating, palpitations, and flank pain, although the pain is not always localized to the costophrenic angle.