Differential Diagnosis for Kidney Stone Suspect

• Single most likely diagnosis
  • Nephrolithiasis (Kidney Stones): This is the most likely diagnosis given the presentation, as kidney stones are a common cause of severe abdominal or flank pain, often accompanied by nausea, vomiting, and hematuria.
• Other Likely diagnoses
  • Urinary Tract Infection (UTI): A UTI can present with similar symptoms to kidney stones, including pain, nausea, and changes in urination. It's a common condition that can coexist with or mimic kidney stones.
  • Pyelonephritis: An infection of the kidney, which can cause severe pain, fever, and other symptoms overlapping with those of kidney stones.
  • Ureteral Obstruction (not due to stones): While less common, obstruction of the ureter from other causes (e.g., blood clots, tumors) can mimic the symptoms of a kidney stone.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Appendicitis: Although the pain pattern differs, appendicitis can sometimes present with pain that might be confused with kidney stone pain, especially if the appendix is located near the kidney. Missing appendicitis can lead to severe consequences.
  • Ectopic Pregnancy: In women, an ectopic pregnancy can cause severe abdominal pain and should always be considered in the differential diagnosis to avoid missing this life-threatening condition.
  • Aortic Dissection or Aneurysm: Severe, tearing chest or abdominal pain can be indicative of an aortic dissection or rupturing aneurysm, conditions that are immediately life-threatening.
• Rare diagnoses
  • Renal Infarction: A rare condition where the blood supply to the kidney is interrupted, leading to tissue death. It can present with severe pain and might be considered in the differential for kidney stone suspects, especially with appropriate risk factors.
  • Retroperitoneal Hemorrhage or Tumor: These conditions can cause flank pain and might be considered in patients with risk factors or when common diagnoses are ruled out.