Differential Diagnosis for Abdominal and Severe Back Pain with Pain in Quadriceps
Single Most Likely Diagnosis
- Musculoskeletal strain or injury: This could involve a strain to the abdominal muscles, back muscles, or a specific injury affecting the quadriceps, such as a quadriceps tendonitis or strain, which could radiate pain to the lower back and abdomen due to referred pain patterns or direct injury.
Other Likely Diagnoses
- Kidney stones (nephrolithiasis): Pain from kidney stones can be severe and is often described as radiating from the flank to the groin. It could also cause abdominal pain and, if the stone is impacting the ureter, could potentially cause referred pain to the quadriceps area.
- Degenerative disc disease or herniated disc: A herniated disc in the lumbar spine could cause severe back pain and radiate pain down to the legs, including the quadriceps area, due to nerve compression.
- Ovarian cysts or torsion (in females): Ovarian cysts can cause abdominal pain, and if they rupture or torsion occurs, the pain can become severe and radiate to the back and potentially down to the thighs.
Do Not Miss Diagnoses
- Abdominal aortic aneurysm (AAA): Although less common, an AAA can cause severe abdominal and back pain and is a medical emergency. The pain can sometimes radiate to the groin and thighs.
- Ectopic pregnancy (in females): Severe abdominal pain with radiation to the back and potentially the thighs, accompanied by vaginal bleeding, could indicate an ectopic pregnancy, which is a life-threatening condition.
- Appendicitis: While classically presenting with right lower quadrant abdominal pain, appendicitis can sometimes cause more diffuse abdominal pain and back pain, especially if the appendix is retrocecal.
Rare Diagnoses
- Psoas abscess: An abscess in the psoas muscle can cause severe back and abdominal pain, and due to the muscle's location, pain can radiate down to the thigh.
- Spinal infections (e.g., osteomyelitis, discitis): Infections of the spine can cause severe back pain and, if the infection spreads or compresses nerves, could cause radiating pain to the legs.
- Retroperitoneal hemorrhage or fibrosis: Bleeding or fibrosis in the retroperitoneal space can cause severe back and abdominal pain and, depending on the structures involved, could radiate pain to the thighs.