Differential Diagnosis for RUQ Abdominal Pain Worse with Movement
Single Most Likely Diagnosis
- Gallbladder Disease (Cholecystitis or Cholelithiasis): This is a common cause of right upper quadrant (RUQ) abdominal pain, which can worsen with movement due to the increased pressure on the gallbladder. The pain is often colicky in nature and can radiate to the right shoulder.
Other Likely Diagnoses
- Peptic Ulcer Disease: Both gastric and duodenal ulcers can cause RUQ pain that worsens with movement. The pain is typically epigastric but can radiate to the RUQ.
- Hepatitis: Inflammation of the liver can cause RUQ pain, especially if the liver is enlarged. Movement can exacerbate the pain due to the liver's increased size and sensitivity.
- Musculoskeletal Issues (e.g., Costochondritis, Intercostal Muscle Strain): These conditions can cause pain in the RUQ that worsens with movement, as the muscles and bones in this area are involved.
Do Not Miss Diagnoses
- Appendicitis (if pain has migrated): Although appendicitis typically presents with pain in the lower right quadrant, it can start in the RUQ and then migrate. Missing this diagnosis can lead to severe consequences, including perforation and peritonitis.
- Pneumonia or Pleurisy: Right lower lobe pneumonia or pleurisy can cause RUQ pain that worsens with movement due to the involvement of the diaphragm and pleura.
- Hepatic Abscess or Liver Tumor: These conditions can cause severe RUQ pain and have significant morbidity and mortality if not promptly diagnosed and treated.
- Cholangitis: Infection of the bile ducts can cause severe RUQ pain, jaundice, and fever. It is a medical emergency requiring prompt intervention.
Rare Diagnoses
- Liver Cysts or Hemangiomas: These benign liver lesions can cause RUQ pain if they rupture or bleed, but they are less common causes of chronic pain.
- Intra-abdominal Malignancies (e.g., Liver, Gallbladder, or Bile Duct Cancers): These are rare but serious causes of RUQ pain. They often present with weight loss, jaundice, and other systemic symptoms in addition to pain.
- Diaphragmatic Hernia: A rare condition where part of the stomach or intestine herniates through the diaphragm, causing RUQ pain that worsens with movement.