Differential Diagnosis for Back Pain and Spot on Back

• Single most likely diagnosis
  • Pilondial cyst: The patient's presentation of a spot on the back that is hurting more with back pain, especially after a fall, is consistent with a pilonidal cyst. These cysts can become inflamed and painful, especially with trauma or pressure on the area.
• Other Likely diagnoses
  • Furuncle or abscess: A boil or abscess in the area could cause similar symptoms, especially if it becomes infected and inflamed.
  • Hematoma: The patient's history of falling down and hurting their back could have resulted in a hematoma, which could be causing the pain and swelling.
  • Contusion: A bruise from the fall could also be causing the pain and discomfort.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Epidural abscess: Although less likely, an epidural abscess is a serious and potentially life-threatening condition that could present with back pain and a focal spot of pain.
  • Spinal epidural hematoma: A hematoma in the spinal epidural space could compress the spinal cord and cause serious neurological symptoms.
  • Osteomyelitis: An infection of the bone could cause pain and swelling in the area, and if left untreated, could lead to serious complications.
• Rare diagnoses
  • Spinal tumor: A tumor in the spine could cause back pain and a focal spot of pain, although this would be a less common cause of the patient's symptoms.
  • Cauda equina syndrome: A rare condition caused by compression of the nerves in the lower spine, which could present with back pain and neurological symptoms.