Differential Diagnosis for Flank Pain, Blood in Urine, and Stone in Left Lower Pole

• Single most likely diagnosis
  • Nephrolithiasis (Kidney Stone): This is the most likely diagnosis given the presence of a stone in the left lower pole, flank pain, and blood in the urine. The stone can cause obstruction and irritation, leading to pain and hematuria.
• Other Likely diagnoses
  • Urinary Tract Infection (UTI): An infection could be secondary to the stone, causing additional symptoms such as dysuria, frequency, and possibly fever.
  • Pyelonephritis: An upper urinary tract infection that could be related to the stone, especially if the stone is causing obstruction.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Renal Cell Carcinoma: Although less likely, a tumor could cause hematuria and pain, and it's crucial to rule out malignancy, especially in the presence of a mass or unexplained hematuria.
  • Ureteropelvic Junction (UPJ) Obstruction: This condition could cause flank pain and potentially hematuria if there's associated stone disease or infection.
  • Sepsis (from an infected stone or obstruction): Infection associated with an obstructing stone can lead to sepsis, a life-threatening condition.
• Rare diagnoses
  • Medullary Sponge Kidney: A rare condition that can cause nephrolithiasis and associated symptoms.
  • Tuberculosis of the Kidney: Could cause chronic pain, hematuria, and might be associated with stone formation, though it's much less common.
  • Vasculitis or other autoimmune diseases affecting the kidneys: Conditions like ANCA-associated vasculitis could cause renal symptoms including pain and hematuria, though they would be less common and might have additional systemic symptoms.