Differential Diagnosis for Right Flank Pain
Single Most Likely Diagnosis
- Nephrolithiasis (Kidney Stones): This is often the first consideration for flank pain due to its prevalence and the characteristic severe, colicky pain it causes, which can radiate to the groin. The pain is typically accompanied by nausea, vomiting, and sometimes blood in the urine.
Other Likely Diagnoses
- Pyelonephritis: An infection of the kidney, which can cause flank pain, fever, and other symptoms like dysuria and frequent urination. It's more common in women and those with urinary tract abnormalities.
- Musculoskeletal Strain: Given the location, strain or injury to the muscles in the flank area can cause significant pain, especially if there's been recent physical activity or trauma.
- Urinary Tract Infection (UTI): While more commonly associated with lower urinary tract symptoms, a UTI can cause flank pain if it ascends to the kidneys.
Do Not Miss Diagnoses
- Appendicitis (if pain is in the lower right flank): Although appendicitis typically presents with pain in the lower right abdomen, it can sometimes be felt in the flank area, especially if the appendix is retrocecal. Missing this diagnosis can lead to perforation and severe complications.
- Pulmonary Embolism: In some cases, a pulmonary embolism can cause referred pain to the flank area, especially if the embolism is large and affects the upper parts of the lung. This is a life-threatening condition that requires immediate attention.
- Aortic Dissection or Aneurysm: These are serious vascular conditions that can cause severe flank pain among other symptoms. They are life-threatening and require immediate medical intervention.
Rare Diagnoses
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic hypertension, sweating, palpitations, and flank pain due to its location near the kidney.
- Renal Cell Carcinoma: A type of kidney cancer that might cause flank pain, although it's more commonly associated with a palpable mass, hematuria, and systemic symptoms like weight loss.
- Epididymitis or Orchitis: Inflammation of the epididymis or testis, respectively, which can cause pain that might be referred to the flank area, especially if the inflammation is severe.