Differential Diagnosis for Hematuria and Flank Pain
Single Most Likely Diagnosis
- Nephrolithiasis (Kidney Stones): This condition is the most common cause of flank pain and hematuria. The pain is often severe and colicky, radiating from the flank to the groin, and can be accompanied by nausea, vomiting, and frequent urination. Hematuria can range from microscopic to gross.
Other Likely Diagnoses
- Pyelonephritis: An infection of the kidney, which can cause flank pain, fever, and hematuria. The pain is typically constant and can be accompanied by symptoms of a urinary tract infection such as dysuria and frequent urination.
- Urinary Tract Infection (UTI): While more commonly associated with lower urinary tract symptoms, upper UTIs can cause flank pain and hematuria, especially if the infection involves the kidneys.
- Glomerulonephritis: An inflammation of the glomeruli, which can cause hematuria, proteinuria, and flank pain. It can be post-infectious or due to other causes like autoimmune diseases.
Do Not Miss Diagnoses
- Renal Cell Carcinoma: Although less common, it's crucial to consider renal cell carcinoma as it can present with hematuria and flank pain. Early detection is key for treatment and prognosis.
- Renal Infarction: A condition where the blood supply to the kidney is interrupted, leading to tissue death. It can cause severe flank pain and hematuria, and is a medical emergency.
- Renal Vein Thrombosis: More common in patients with nephrotic syndrome or dehydration, it can cause flank pain and hematuria. It's a serious condition that requires prompt diagnosis and treatment.
Rare Diagnoses
- Vasculitis (e.g., ANCA-associated vasculitis): A group of diseases that involve inflammation of the blood vessels, which can affect the kidneys and cause hematuria and flank pain.
- Sickle Cell Disease: Can cause renal complications including papillary necrosis, which may present with hematuria and flank pain.
- Renal Artery Aneurysm: A rare condition that can cause flank pain and hematuria if the aneurysm ruptures or causes renal ischemia.
- Tuberculosis of the Kidney: A form of extrapulmonary tuberculosis that can cause chronic flank pain, hematuria, and other urinary symptoms.